Provider Demographics
NPI:1083637581
Name:CLASEN, WILLIAM E (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:CLASEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12106 TRENTMORE PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1407
Mailing Address - Country:US
Mailing Address - Phone:314-843-6154
Mailing Address - Fax:
Practice Address - Street 1:305 HOVEN DR
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-1157
Practice Address - Country:US
Practice Address - Phone:636-257-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO027974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist