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Organization

SPECIALTY PHARMACY OF ST. LOUIS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEE ERIC ORI PHARMD (PRESIDENT)
(314) 991-5200
Entity
Organization

Contact information

Practice address
623 N NEW BALLAS RD, CREVE COEUR, MO 63141-6713
(314) 991-5200
(314) 991-5210
Mailing address
623 N NEW BALLAS RD, CREVE COEUR, MO 63141-6713
(314) 991-5200
(314) 991-5210

Taxonomy

Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
2003001140
MO
3336S0011X
Specialty Pharmacy
2003001140
MO

Other

Enumeration date
08/16/2007
Last updated
08/16/2007
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