Provider Demographics
NPI:1275794588
Name:SCHMITTGENS, MERRY L (RPH)
Entity Type:Individual
Prefix:
First Name:MERRY
Middle Name:L
Last Name:SCHMITTGENS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MERRY
Other - Middle Name:LYNN
Other - Last Name:STEPHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:7922 MACKENZIE RD
Mailing Address - Street 2:
Mailing Address - City:AFFTON
Mailing Address - State:MO
Mailing Address - Zip Code:63123-2721
Mailing Address - Country:US
Mailing Address - Phone:314-638-3535
Mailing Address - Fax:314-638-0351
Practice Address - Street 1:7922 MACKENZIE RD
Practice Address - Street 2:
Practice Address - City:AFFTON
Practice Address - State:MO
Practice Address - Zip Code:63123-2721
Practice Address - Country:US
Practice Address - Phone:314-638-3535
Practice Address - Fax:314-638-0351
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO042337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist