Provider Demographics
NPI:1326047523
Name:LEVY, HEDVA
Entity Type:Individual
Prefix:
First Name:HEDVA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9648 OLIVE BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3002
Mailing Address - Country:US
Mailing Address - Phone:314-994-9409
Mailing Address - Fax:
Practice Address - Street 1:9648 OLIVE BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3002
Practice Address - Country:US
Practice Address - Phone:314-994-9409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044347183500000X, 1835G0303X
KY010324183500000X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric