Organization
MEDBANK PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAYTHAM MOSTAFA RPH (PHARMACY OWNER AND MANAGER)
(314) 662-7597
Entity
Organization
Contact information
Practice address
637 DUNN RD STE 100, HAZELWOOD, MO 63042-1755
(314) 662-7597
Mailing address
1003 CENTURY OAKS DR APT H, MANCHESTER, MO 63088-1259
(314) 662-7597
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
02/17/2019
Last updated
02/17/2019
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