Organization
MEDICAL WEST PHARMACY INC
Active
Other names
MEDICAL WEST HEALTHCARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH ALAN SANDLER (PRESIDENT)
(314) 725-1888
Entity
Organization
Contact information
Practice address
444 S BRENTWOOD BLVD, SAINT LOUIS, MO 63105-2521
(314) 725-1888
(314) 725-1444
Mailing address
9301 DIELMAN INDUSTRIAL DR, SAINT LOUIS, MO 63132-2204
(314) 993-7900
(314) 569-5056
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
10803009
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105140
HEALTHLINK
MO
01
—
29775
BLUE CROSS BLUE SHIELD
MO
05
—
620200907
—
MO
01
—
8200064
UNITED HEALTHCARE
MO
05
—
850200908
—
MO
Enumeration date
12/13/2005
Last updated
02/25/2009
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