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General NPI Number Information
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NPI Number | 1932570108
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Entity Type | Organization
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Legal Business Name | MISSOURI HEALTH INFUSION
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 2319 WELDON PKWY
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3207
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Country | US
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Telephone | 866-575-7775
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Fax | 314-480-7123
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Provider Business Mailing Address
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Address Line | 2319 WELDON PKWY
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3207
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Country | US
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Telephone | 866-575-7775
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Fax | 314-480-7123
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA SILVA
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Credential |
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Telephone | 314-396-6711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2015036497
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License Number State | MO
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