MEDICARE: HEDVA LEVY

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
1	183500000X	Pharmacist	044347	MO
2	183500000X	Pharmacist	010324	KY
3	1835G0303X	Geriatric Pharmacist	044347	MO
4	1835G0303X	Geriatric Pharmacist	010324	KY

General Provider Information

NPI Number	:	1326047523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEDVA LEVY

Provider Business Mailing Address
First Line	:	9648 OLIVE BLVD
Second Line	:	SUITE 309
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3002
Country	:	US
Telephone Number	:	314-994-9409
Fax Number	:

Provider Business Practice Location Address
First Line	:	9648 OLIVE BLVD
Second Line	:	SUITE 309
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3002
Country	:	US
Telephone Number	:	314-994-9409
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	01/07/2008

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Directions to “ HEDVA LEVY ” Practice Location

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