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NPI Code Detail

MEDICARE: WASHINGTON UNIVERSITY

MEDICARE: WASHINGTON UNIVERSITY
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 Pharmacy2010026615MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12639219OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1518272673
Entity Type Code : Organization
Provider Name (Legal Business Name) : WASHINGTON UNIVERSITY
Provider Business Mailing Address
First Line : 10 BARNES WEST DR
Second Line : BUILDING 2, SUITE 100
City : SAINT LOUIS
State : MO
Zip : 63141-6350
Country : US
Telephone Number : 314-996-3403
Fax Number : 314-996-3385
Provider Business Practice Location Address
First Line : 10 BARNES WEST DR
Second Line : BUILDING 2, SUITE 100
City : SAINT LOUIS
State : MO
Zip : 63141-6350
Country : US
Telephone Number : 314-996-3403
Fax Number : 314-996-3385
Authorized Official
Title or Position : PHARMACIST-IN-CHARGE
Name : MELINDA CORLEY
Credential : RPH
Telephone Number : 314-996-3403
Provider Enumeration Date : 08/13/2010
Last Update Date : 11/01/2017

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Directions to “WASHINGTON UNIVERSITY ” Practice Location

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