Organization
DIERBERGS MARKETS INC
Active
Other names
DIERBERGS WENTZVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GUENTHER (DIRECTOR OF PHARMACY)
(636) 812-1470
Entity
Organization
Contact information
Practice address
1820 WENTZVILLE PARKWAY, WENTZVILLE, MO 63385
(636) 887-3317
(636) 530-3006
Mailing address
PO BOX 1070, CHESTERFIELD, MO 63006-1070
(636) 812-1470
(636) 812-1603
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2006008312
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636530
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
606251908
—
MO
Enumeration date
10/13/2006
Last updated
01/30/2009
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