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Organization
DIERBERGS MARKETS INC
Active
Organization
DIERBERGS MARKETS INC
Active
Other names
DIERBERGS SOUTHROADS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GUENTHER (DIRECTOR OF PHARMACY)
(636) 812-1470
Entity
Organization
Contact information
Practice address
12420 TESSON FERRY RD, SAINT LOUIS, MO 63128-2702
(314) 849-3880
(636) 530-3001
Mailing address
PO BOX 1070, CHESTERFIELD, MO 63006-1070
(636) 812-1470
(636) 812-1603
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
005302
MO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2627531
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
603681404
—
MO
Enumeration date
10/12/2006
Last updated
04/04/2014
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