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General NPI Number Information
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NPI Number | 1740648476
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Entity Type | Organization
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Legal Business Name | ALICIA B BARISHMAN
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 991 HAVERSHAM DR
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City | SAINT CHARLES
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State | MO
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Zip | 63304-1645
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Country | US
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Telephone | 314-972-2259
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Fax |
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Provider Business Mailing Address
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Address Line | 991 HAVERSHAM DR
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City | SAINT CHARLES
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State | MO
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Zip | 63304-1645
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Country | US
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Telephone | 314-972-2259
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Fax |
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Authorized Official
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Title or Position | REGISTERED PHARMACIST
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Name | MS. ALICIA B BARISHMAN
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Credential | RPH
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Telephone | 314-972-2259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PS30150
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License Number State | FL
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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 | PH044156
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License Number State | MO
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