# SCHNUCK MARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Schnucks Pharmacy 232
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780169540
- **Authorized official:** LISA M DOBBS (MANAGER OF THIRD PARTY)
- **Authorized official phone:** (314) 994-4902

## Contact information

- **Practice address:** 2122 TROY RD, EDWARDSVILLE, IL 62025-2540
- **Practice address phone:** (618) 655-0386
- **Practice address fax:** (618) 655-0394
- **Mailing address:** 11420 LACKLAND RD, SAINT LOUIS, MO 63146-3559
- **Mailing address phone:** (314) 994-4902
- **Mailing address fax:** (314) 994-4586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WD0400X | Diabetes Educator Registered Nurse | — | NULL | — |
| 163WD0400X | Diabetes Educator Registered Nurse | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2018
- **Last updated:** 01/27/2019