NPI Profile for DIERBERGS MARKETS INCORPORATED in FENTON, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X | |||
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1538258207 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/12/2006 | |
| Last updated | 03/16/2021 - About 5 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DIERBERGS MARKETS, INCORPORATED
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