Organization
LADUE PHARMACY LLC
Active
Other names
Ladue Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RICK WILLIAMS (MEMBER)
(314) 993-4031
Entity
Organization
Contact information
Practice address
9832 CLAYTON RD, SAINT LOUIS, MO 63124-1604
(314) 993-4031
(314) 993-0306
Mailing address
9832 CLAYTON RD, SAINT LOUIS, MO 63124-1604
(314) 993-4031
(314) 993-0306
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
6534
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175165
PK
—
05
—
600899900
—
MO
Enumeration date
12/29/2017
Last updated
07/19/2018
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