Individual
BRANDON GLEN ELDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1504 S GRAND BLVD, SAINT LOUIS, MO 63104-1304
(314) 535-3334
(314) 535-3337
Mailing address
1504 S GRAND BLVD, SAINT LOUIS, MO 63104-1304
(314) 535-3334
(314) 535-3337
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.294668
IL
183500000X
Pharmacist
Primary
2009020986
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600447627
—
MO
Enumeration date
07/27/2009
Last updated
09/01/2015
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