Organization
JSB GROUP LLC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GUINN RPH (MEDICAID MEDICARE BILLING SPEC)
(314) 993-6000
Entity
Organization
Contact information
Practice address
2386 N HIGHWAY 67, FLORISSANT, MO 63033-2034
(314) 921-7700
(314) 921-3520
Mailing address
12130 LADUE RD, SAINT LOUIS, MO 63141-8121
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
19406169
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22038815
—
MO
01
—
2615752
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
600658108
—
MO
Enumeration date
08/20/2006
Last updated
10/16/2008
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