Organization
FITZPATRICK PHARMACY INC
Active
Other names
FITZPATRICK PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RATHGEBER RPH (OWNER)
(636) 394-6622
Entity
Organization
Contact information
Practice address
15394 MANCHESTER RD, BALLWIN, MO 63011-3052
(636) 394-6622
(636) 394-9222
Mailing address
15394 MANCHESTER RD, BALLWIN, MO 63011-3052
(636) 394-6622
(636) 394-9222
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PS006166
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049588
PK
—
05
—
600397301
—
MO
05
—
620397307
—
MO
Enumeration date
09/12/2006
Last updated
01/17/2017
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