Organization
TOMLYN, INC
Active
Other names
Medicine Shoppe, Medicine Shoppe 0128
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ALEXANDER WANG PHARMD (PRESIDENT)
(314) 753-8851
Entity
Organization
Contact information
Practice address
7922 MACKENZIE RD, AFFTON, MO 63123-2721
(314) 638-3535
(314) 638-0351
Mailing address
7922 MACKENZIE ROAD, AFFTON, MO 63123-2721
(314) 638-3535
(314) 638-0351
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
MO
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2613859
NABP
MO
05
—
600307706
—
MO
05
—
620307702
—
MO
Enumeration date
10/02/2006
Last updated
06/11/2024
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