Organization
JSH GROUP LLC
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUNG Y BAE RPH (PHARMACIST IN CHARGE)
(314) 428-7676
Entity
Organization
Contact information
Practice address
4441BROWN ROAD, ST. LOUIS, MO 63134
(314) 428-7676
(314) 428-1701
Mailing address
4441BROWN ROAD, ST. LOUIS, MO 63134
(314) 428-7676
(314) 428-1701
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2000148820
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2628216
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
600243505
—
MO
Enumeration date
08/20/2006
Last updated
03/26/2010
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