Organization
JPRX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX VAYMAN PHARM D (PRESIDENT)
(314) 842-0910
Entity
Organization
Contact information
Practice address
11330 GRAVOIS RD, SUITE 202, SAPPINGTON, MO 63126-3608
(314) 842-0910
(314) 842-7982
Mailing address
11330 GRAVOIS RD, SUITE 202, SAPPINGTON, MO 63126-3608
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
006114
MO
3336L0003X
Long Term Care Pharmacy
0061144
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2627404
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
602357105
—
MO
Enumeration date
10/03/2006
Last updated
01/18/2019
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