MEDICARE: DNG PHARMACEUTICALS

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	3336C0003X	Community/Retail Pharmacy	2007033165	MO
2	3336C0002X	Clinic Pharmacy		MO

General Provider Information

NPI Number	:	1487857090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DNG PHARMACEUTICALS

Provider Business Mailing Address
First Line	:	2331 HAMPTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-2908
Country	:	US
Telephone Number	:	314-772-1444
Fax Number	:	314-772-0600

Provider Business Practice Location Address
First Line	:	2331 HAMPTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-2908
Country	:	US
Telephone Number	:	314-772-1444
Fax Number	:	314-772-0600

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DEVON NORTHON GOLDING
Credential	:
Telephone Number	:	314-772-1444

Provider Enumeration Date	:	06/10/2007
Last Update Date	:	10/22/2007

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Directions to “DNG PHARMACEUTICALS ” Practice Location

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