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PEVELY RX NPI 1790034064


NPI Information

NPI: 1790034064
Provider Name: PEVELY RX

Doing Business As: THE MEDICINE SHOPPE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 26D2048223

Address:
8640 COMMERCIAL BLVD
PEVELY, MO
ZIP 63070
Phone: (636) 479-6100
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PEVELY RX is a community/retail pharmacy pharmacy in Pevely, MO. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. PEVELY RX NPI is 1790034064. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As The Medicine Shoppe Pharmacy.

The provider's business location address is:

8640 COMMERCIAL BLVD
PEVELY, MO
ZIP 63070-529
Phone: (636) 479-6100
Fax: (636) 479-6101

The provider's authorized official is Jason Wang .
The authorized official title is President and has the following contact phone number (314) 753-8851.

The CLIA number assigned to this NPI record is 26D2048223 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/2/2012 and was last updated on 3/13/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WD0400XRegistered NurseDiabetes EducatorNo
23336C0003XPharmacyCommunity/Retail Pharmacy2012030942MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12136810OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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