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General NPI Number Information
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NPI Number | 1730521139
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Entity Type | Individual
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Provider Name | STEVE ALAN GRANT JR. PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 9320 LACKLAND RD
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City | OVERLAND
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State | MO
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Zip | 63114-5458
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Country | US
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Telephone | 314-429-4636
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Fax | 314-429-8664
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Provider Business Mailing Address
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Address Line | 9320 LACKLAND RD
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City | SAINT LOUIS
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State | MO
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Zip | 63114-5458
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Country | US
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Telephone | 314-429-4636
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Fax | 314-429-8664
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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 | 17500
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License Number State | AL
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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 | 2019046068
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License Number State | MO
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