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NPI Code Detail

MEDICARE: MILLBROOK PHARMACY, INC

MEDICARE: MILLBROOK PHARMACY, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1033519251
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILLBROOK PHARMACY, INC
Provider Business Mailing Address
First Line : 9832 CLAYTON RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63124-1604
Country : US
Telephone Number : 314-993-4031
Fax Number :
Provider Business Practice Location Address
First Line : 7010 PERSHING AVE
Second Line :
City : UNIVERSITY CITY
State : MO
Zip : 63130-4318
Country : US
Telephone Number : 314-993-4031
Fax Number :
Authorized Official
Title or Position : PRES
Name : RICHARD S WILLIAMS
Credential :
Telephone Number : 314-993-4031
Provider Enumeration Date : 08/25/2014
Last Update Date : 08/25/2014

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Directions to “MILLBROOK PHARMACY, INC ” Practice Location

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