Provider Demographics
NPI:1093498925
Name:THE PLACE ON WASHINGTON LLC
Entity Type:Organization
Organization Name:THE PLACE ON WASHINGTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-624-5575
Mailing Address - Street 1:231 S BEMISTON AVE STE 850
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1920
Mailing Address - Country:US
Mailing Address - Phone:314-624-5575
Mailing Address - Fax:314-921-2642
Practice Address - Street 1:1130 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-1122
Practice Address - Country:US
Practice Address - Phone:314-624-5575
Practice Address - Fax:314-921-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy