Organization
PROFESSIONAL PRESCRIPTION SERVICES LLC
Active
Other names
Parkland Health Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS RADEMAKER RPH (MANAGING MEMBER)
(636) 933-2224
Entity
Organization
Contact information
Practice address
348 FESTUS CENTRE DR, FESTUS, MO 63028-2458
(636) 933-2224
(636) 933-2264
Mailing address
1131 N DESLOGE DR, DESLOGE, MO 63601-2936
(573) 431-6677
(573) 431-3833
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2004029045
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049048
PK
—
05
—
606159507
—
MO
Enumeration date
09/20/2005
Last updated
06/23/2022
Update your record
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