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General NPI Number Information
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NPI Number | 1720038466
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Entity Type | Individual
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Provider Name | AMY RACKERS RPH
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 4921 PARKVIEW PL
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1032
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Country | US
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Telephone | 314-454-7666
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Fax |
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Provider Business Mailing Address
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Address Line | 216 S KINGSHIGHWAY BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1026
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Country | US
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Telephone | 314-362-2932
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2004006517
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 51286206
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License Number State | IL
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