Provider Demographics
NPI:1194000984
Name:ANTHONY-JONES, IRENE (PHARMD)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:ANTHONY-JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5790 LUCAS AND HUNT RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1135
Mailing Address - Country:US
Mailing Address - Phone:314-382-5114
Mailing Address - Fax:314-383-0599
Practice Address - Street 1:5790 LUCAS AND HUNT RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1135
Practice Address - Country:US
Practice Address - Phone:314-382-5114
Practice Address - Fax:314-383-0599
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007035705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist