Provider Demographics
NPI:1447736624
Name:SIMPSON, KENNETH (RPH)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 HAMPTON VILLAGE PLZ
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2127
Mailing Address - Country:US
Mailing Address - Phone:314-832-7700
Mailing Address - Fax:314-832-7590
Practice Address - Street 1:60 HAMPTON VILLAGE PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2127
Practice Address - Country:US
Practice Address - Phone:314-832-7700
Practice Address - Fax:314-832-7590
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO030064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO030064OtherMISSOURI STATE BOARD OF PHARMACY