Organization
SSM HEALTH CARE ST LOUIS
Active
Other names
SSM St. Joseph Hospital-Wentzville Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SPENCER (V.P. PHARMACY SERVICES)
(314) 989-2588
Entity
Organization
Contact information
Practice address
500 MEDICAL DR, WENTZVILLE, MO 63385-3421
(636) 327-1008
(636) 327-1080
Mailing address
12312 OLIVE BLVD, SUITE 500, SAINT LOUIS, MO 63141-6448
(314) 523-8776
(314) 523-8774
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2005037444
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148633
PK
—
05
—
600019812
—
MO
Enumeration date
11/26/2014
Last updated
10/18/2022
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