MEDICARE: NANCY A PARK PHARM.D.

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	044308	MO
2	183500000X	Pharmacist	PS31782	FL

General Provider Information

NPI Number	:	1558579821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY A PARK PHARM.D.

Provider Business Mailing Address
First Line	:	7427 OXFORD DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-2915
Country	:	US
Telephone Number	:	314-409-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	7427 OXFORD DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-2915
Country	:	US
Telephone Number	:	314-409-2020
Fax Number	:

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

Provider Enumeration Date	:	05/19/2007
Last Update Date	:	07/08/2007

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Directions to “ NANCY A PARK PHARM.D.” Practice Location

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