Provider Demographics
NPI:1417382227
Name:CHOLLET, PATRICIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:CHOLLET
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S KIRKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6117
Mailing Address - Country:US
Mailing Address - Phone:314-394-2404
Mailing Address - Fax:314-394-2120
Practice Address - Street 1:301 S KIRKWOOD RD
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6117
Practice Address - Country:US
Practice Address - Phone:314-394-2404
Practice Address - Fax:314-394-2120
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0040975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0040975OtherMISSOURI BOARD OF PHARMACY