Individual
DR. SAMUEL JAMES IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
3430 S GRAND BLVD, SAINT LOUIS, MO 63118-1004
(314) 772-5722
Mailing address
3430 S GRAND BLVD, SAINT LOUIS, MO 63118-1004
(314) 752-5722
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2019024410
MO
Other
Enumeration date
12/28/2019
Last updated
12/28/2019
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