Provider Demographics
NPI:1447779848
Name:DOCTORS PHARMACY OF MOSCOW MILLS
Entity Type:Organization
Organization Name:DOCTORS PHARMACY OF MOSCOW MILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SCHOEDINGER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:314-303-1205
Mailing Address - Street 1:244 COLLEGE CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:MOSCOW MILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63362-1176
Mailing Address - Country:US
Mailing Address - Phone:636-366-5445
Mailing Address - Fax:636-366-5450
Practice Address - Street 1:244 COLLEGE CAMPUS DR
Practice Address - Street 2:
Practice Address - City:MOSCOW MILLS
Practice Address - State:MO
Practice Address - Zip Code:63362-1176
Practice Address - Country:US
Practice Address - Phone:636-366-5445
Practice Address - Fax:636-366-5450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017032080333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy