Individual
DR. IVAN RIVERA-VARGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
5764 S LINDBERGH BLVD, SAINT LOUIS, MO 63123-6937
(314) 842-3340
Mailing address
5764 S. LINDBERGH, ST. LOUIS, MO 63123
(314) 842-3340
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2003017168
MO
Other
Enumeration date
10/01/2011
Last updated
10/01/2011
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