Organization
CHRISTIAN HOSPITAL NORTHEAST NORTHWEST
Active
Other names
Family Care Pharmacy at Graham Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WEHKING (SUPERVISOR)
(314) 953-6740
Entity
Organization
Contact information
Practice address
1224 GRAHAM RD, FLORISSANT, MO 63031-8028
(314) 953-6740
(314) 953-6921
Mailing address
1224 GRAHAM RD, FLORISSANT, MO 63031-8028
(314) 953-6740
(314) 953-6921
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PS005673
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2625424
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
606763506
—
MO
Enumeration date
08/22/2006
Last updated
09/06/2012
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