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General NPI Number Information
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NPI Number | 1902836182
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Entity Type | Organization
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Legal Business Name | HUNT FITZ DRUG, INC.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 5346 DEVONSHIRE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2304
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Country | US
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Telephone | 314-352-5201
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Fax | 314-352-5205
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Provider Business Mailing Address
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Address Line | 5346 DEVONSHIRE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2304
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Country | US
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Telephone | 314-352-5201
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Fax | 314-352-5205
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | MRS. PAULA K. WEAVER
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Credential | RPH
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Telephone | 314-352-5201
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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 | MO5619
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License Number State | MO
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