Organization
O'FALLON PHARMACY, LLC
Active
Other names
Cardinal Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SIERRA DEGOMEZ (MANAGING MEMBER)
(833) 347-4217
Entity
Organization
Contact information
Practice address
108 TRIAD CTR W, O FALLON, MO 63366-7541
(833) 347-4217
(877) 646-0735
Mailing address
108 TRIAD CTR W, O FALLON, MO 63366-7541
(833) 347-4217
(877) 646-0735
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/28/2020
Last updated
12/08/2020
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