Provider Demographics
NPI:1164173787
Name:WEISHAAR, TREY (PHARMD)
Entity Type:Individual
Prefix:
First Name:TREY
Middle Name:
Last Name:WEISHAAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6038 ARSENAL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-2623
Mailing Address - Country:US
Mailing Address - Phone:314-229-5724
Mailing Address - Fax:
Practice Address - Street 1:1861 CRAIG PARK CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4122
Practice Address - Country:US
Practice Address - Phone:314-229-5724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017038799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist