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Organization

DIERBERGS MARKETS, INCORPORATED

Active
Parent organization
DIERBERGS MARKETS, INCORPORATED
Other names
DIERBERGS FENTON CROSSING PHARMACY
Organization subpart
Yes

Provider details

NPI number
Legal business name
DIERBERGS MARKETS, INCORPORATED
Authorized official
GREG GUENTHER (PHARMACY DIRECTOR)
(636) 812-1472
Entity
Organization

Contact information

Practice address
450 OLD SMIZER MILL RD., FENTON, MO 63026
(636) 349-2666
(636) 530-3018
Mailing address
450 OLD SMIZER MILL RD., FENTON, MO 63026
(636) 349-2666
(636) 530-3018

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
333600000X
Pharmacy
2000158538
MO
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2633584
OTHER ID NUMBER-COMMERCIAL NUMBER
05
605711704
MO
Enumeration date
10/12/2006
Last updated
03/16/2021
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