Organization
LAND P INC
Active
Other names
WHARF PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY PALANS RPH (OWNER)
(636) 561-3191
Entity
Organization
Contact information
Practice address
300 MEDICAL PLZ STE 110, LAKE ST LOUIS, MO 63367-1482
(636) 561-5627
(636) 561-5628
Mailing address
300 MEDICAL PLZ STE 110, LAKE ST LOUIS, MO 63367-1482
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636427
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/22/2006
Last updated
09/13/2007
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