Organization
MISSOURI LTC PHARMACY LLC
Active
Other names
Infinium Pharmacy - Republic
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE S CERIOTTI RPH (CHIEF OPERATING OFFICER)
(314) 690-4500
Entity
Organization
Contact information
Practice address
6129 W US HIGHWAY 60, BROOKLINE, MO 65619-9441
(417) 708-5050
(417) 708-5055
Mailing address
6129 W US HIGHWAY 60, BROOKLINE, MO 65619-9441
(417) 708-5050
(417) 708-5055
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
2017040311
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242178407
—
AR
05
—
600049471
—
MO
Enumeration date
10/24/2017
Last updated
12/29/2025
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