# SSM PHARMACY @ DEPAUL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699861674
- **Authorized official:** MR. BRADLEY ARENS RPH (MANGER/PIC)
- **Authorized official phone:** (314) 344-7300

## Contact information

- **Practice address:** 12255 DE PAUL DR STE 120, BRIDGETON, MO 63044-2513
- **Practice address phone:** (314) 344-7300
- **Practice address fax:** (314) 344-6179
- **Mailing address:** 12255 DE PAUL DR STE 120, BRIDGETON, MO 63044-2513
- **Mailing address phone:** (314) 344-7300
- **Mailing address fax:** (314) 344-6179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 42638 | MO | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 08/22/2020