Organization
ST ANTHONYS PROFESSIONAL PHARMACY LLC
Active
Other names
ST ANTHONYS RETAIL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEN VENUTO RPH (CFO)
(314) 525-7340
Entity
Organization
Contact information
Practice address
10004 KENNERLY RD, SUITE 130, SAINT LOUIS, MO 63128-2141
(314) 525-4777
(314) 525-4642
Mailing address
12700 SOUTHFORK RD, SUITE 110, SAINT LOUIS, MO 63128-3201
(314) 525-4488
(314) 525-4810
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2000160057
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047126
PK
—
05
—
600307409
—
MO
Enumeration date
06/22/2006
Last updated
03/14/2016
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