Organization
DIERBERGS MARKETS INC
Active
Other names
DIERBERGS GREEN MOUNT CROSSING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GUENTHER (DIRECTOR OF PHARMACY)
(636) 812-1470
Entity
Organization
Contact information
Practice address
4000 GREEN MOUNT CROSSING DR, SHILOH, IL 62269-7287
(618) 628-8085
(636) 530-3000
Mailing address
PO BOX 1070, CHESTERFIELD, MO 63006-1070
(636) 812-1470
(636) 812-1603
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5401987
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1476161
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/12/2006
Last updated
01/30/2009
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