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General NPI Number Information
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NPI Number | 1730244161
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Entity Type | Organization
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Legal Business Name | IMRAN PHARMACY
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 3737 N KINGSHIGHWAY BLVD STE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63115-1736
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Country | US
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Telephone | 314-381-9394
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Fax | 314-381-8833
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Provider Business Mailing Address
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Address Line | 3737 N KINGSHIGHWAY BLVD STE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63115-1736
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Country | US
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Telephone | 314-381-9394
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Fax | 314-381-8833
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Authorized Official
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Title or Position | PIC
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Name | REHAN RANA
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Credential |
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Telephone | 731-730-2092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5995
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License Number State | MO
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