Organization
GATEWAY APOTHECARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL ELIZABETH SIERBINSKI PHARMD (PHARMACIST IN CHARGE)
(314) 381-1818
Entity
Organization
Contact information
Practice address
4473 FOREST PARK AVE, SAINT LOUIS, MO 63108-2211
(314) 381-1818
(314) 667-3202
Mailing address
1905 BRANCH RD, FENTON, MO 63026-2613
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2011027321
MO
3336L0003X
Long Term Care Pharmacy
2011027321
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133068
PK
—
Enumeration date
12/11/2011
Last updated
03/12/2018
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