Organization
GASAWAY PBA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SHIPLEY (PRESIDENT)
(636) 928-1550
Entity
Organization
Contact information
Practice address
104 JUNGERMANN RD, SAINT PETERS, MO 63376-1608
(636) 928-1550
(636) 447-7168
Mailing address
104 JUNGERMANN RD, SAINT PETERS, MO 63376-1608
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5437
MO
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2619863
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/23/2006
Last updated
09/11/2025
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