National Provider Identifier Database

DIERBERGS TOWN CENTER PHARMACY
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

DIERBERGS TOWN CENTER PHARMACY
2460 TAYLOR ROAD
WILDWOOD, MO63040
Phone: 636-458-7450
Fax:
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for DIERBERGS TOWN CENTER PHARMACY

NPI Number 1710359484
Legal business name
LBN
DIERBERGS TOWN CENTER PHARMACY
Authorized official BRENDA MCDANIEL - (STAFF PHARMACIST)
Entity Organization
Organization subpart No
Enumeration date 10/21/2015
Last updated 10/21/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 2003031656
  • MO Medicaid: 606120103

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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