Organization
FOREST PARK PHARMACY
Active
Other names
FOREST PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMIRA JAHIC (VICE PRESIDENT)
(314) 645-9990
Entity
Organization
Contact information
Practice address
3535 S. JEFFERSON AVE, STE (S-1), ST LOUIS, MO 63118
(314) 645-9990
(314) 645-9989
Mailing address
3535 SOUTH JEFFERSON AVE, STE S-1, ST LOUIS, MO 63118-3900
(314) 645-9990
(314) 645-9989
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2007014550
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2637429
OTHER ID NUMBER
—
Enumeration date
06/15/2007
Last updated
03/09/2017
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