Organization
CLARKSON SQUARE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT WILLIAMS (PRESIDENT)
(636) 532-6060
Entity
Organization
Contact information
Practice address
1737 CLARKSON RD, CHESTERFIELD, MO 63017-4977
(636) 532-6060
(636) 532-5001
Mailing address
1737 CLARKSON RD, CHESTERFIELD, MO 63017-4977
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4170
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2620309
OTHER ID NUMBER
—
Enumeration date
10/03/2006
Last updated
09/13/2007
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