MEDICARE: DR. KELLY MICKEY PHARMD

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	2018036662	MO

General Provider Information

NPI Number	:	1629545868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY MICKEY PHARMD

Provider Business Mailing Address
First Line	:	7255 DELMAR BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-4105
Country	:	US
Telephone Number	:	269-214-1559
Fax Number	:

Provider Business Practice Location Address
First Line	:	7255 DELMAR BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-4105
Country	:	US
Telephone Number	:	269-214-1559
Fax Number	:

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

Provider Enumeration Date	:	10/25/2018
Last Update Date	:	01/16/2020

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1548343544 — DR. LISA J. MCDONALD DMD
Practice Location Address:

7247 DELMAR BLVD
SAINT LOUIS, MO
63130-4105

Practice Phone: 314-727-1319
Practice Fax:

1801963012 — JANE WRIGHT SEELIG MA,LPC, ATR,BC
Practice Location Address:

7243 DELMAR BLVD , SUITE 201
ST. LOUIS, MO
63130-4105

Practice Phone: 314-832-7340
Practice Fax: 314-832-7340

1942338777 — DANIEL T. SULLIVAN D.D.S.
Practice Location Address:

7247 DELMAR BLVD
SAINT LOUIS, MO
63130-4105

Practice Phone: 314-727-1319
Practice Fax: 314-727-7221

1982174256 — KK APOTHECARY, LLC
Practice Location Address:

7255 DELMAR BLVD
SAINT LOUIS, MO
63130-4105

Practice Phone: 269-214-1559
Practice Fax:

1285259796 — DR. SARA CORRIGAN DMD
Practice Location Address:

7247 DELMAR BLVD
SAINT LOUIS, MO
63130-4105

Practice Phone: 314-727-1319
Practice Fax:

Directions to “ DR. KELLY MICKEY PHARMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.