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General NPI Number Information
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NPI Number | 1760486781
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Entity Type | Organization
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Legal Business Name | M.D. PHARMACY INC
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 8390 DELMAR BLVD
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City | UNIVERSITY CITY
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State | MO
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Zip | 63124-2117
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Country | US
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Telephone | 314-991-1111
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Fax | 314-991-2338
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Provider Business Mailing Address
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Address Line | 8500 DELMAR BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2111
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Country | US
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Telephone | 314-991-1111
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Fax | 314-991-2338
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Authorized Official
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Title or Position | CEO - MD PHARMACY
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Name | MR. JAMES A CORDES
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Credential | RPH, MBA
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Telephone | 314-991-1111
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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 | 02337
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License Number State | MO
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