Provider Demographics
NPI:1497815989
Name:PHARMACY OPERATIONS, INC
Entity Type:Organization
Organization Name:PHARMACY OPERATIONS, INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-872-5324
Mailing Address - Street 1:1 RIDER TRAIL PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63045
Mailing Address - Country:US
Mailing Address - Phone:314-872-5539
Mailing Address - Fax:314-872-5335
Practice Address - Street 1:1000 BUSINESS 190
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3285
Practice Address - Country:US
Practice Address - Phone:985-892-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13677333600000X
LA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1233901Medicaid
1929542OtherNABP#
LABP9603829OtherDEA #
LA0584270067Medicare NSC