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Organization
DIERBERGS MARKETS INC
Active
Organization
DIERBERGS MARKETS INC
Active
Other names
DIERBERGS GREEN MOUNT CROSSING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GUENTHER (DIRECTOR OF PHARMACY)
(636) 812-1470
Entity
Organization
Contact information
Practice address
4000 GREEN MOUNT CROSSING DR, SHILOH, IL 62269-7287
(618) 628-8085
(636) 530-3000
Mailing address
PO BOX 1070, CHESTERFIELD, MO 63006-1070
(636) 812-1470
(636) 812-1603
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5401987
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1476161
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/12/2006
Last updated
01/30/2009
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