Provider Demographics
NPI:1235427576
Name:SCATCHERD, STACY L (BS IN PHARMACY)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:L
Last Name:SCATCHERD
Suffix:
Gender:F
Credentials:BS IN PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 RUSTY RD.
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128
Mailing Address - Country:US
Mailing Address - Phone:314-894-7952
Mailing Address - Fax:314-894-7973
Practice Address - Street 1:4200 RUSTY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-1973
Practice Address - Country:US
Practice Address - Phone:314-894-7952
Practice Address - Fax:314-894-7973
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002022593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist