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General NPI Number Information
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NPI Number | 1740545169
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Entity Type | Organization
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Legal Business Name | MILLENIUM CORPORATION
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 763 S NEW BALLAS RD STE 100
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City | CREVE COEUR
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State | MO
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Zip | 63141-8711
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Country | US
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Telephone | 215-968-3130
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Fax |
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Provider Business Mailing Address
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Address Line | 763 S NEW BALLAS RD SUITE 100
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City | CREVE COEUR
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State | MO
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Zip | 63141-8704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NAVNEET GREWAL
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Credential |
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Telephone | 610-724-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2012030481
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License Number State | MO
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