Provider Demographics
NPI:1558443911
Name:ESI MAIL PHARMACY SERVICE INC
Entity Type:Organization
Organization Name:ESI MAIL PHARMACY SERVICE INC
Other - Org Name:EXPRESS SCRIPTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEPPERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-858-4916
Mailing Address - Street 1:4600 NORTH HANLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63134-2715
Mailing Address - Country:US
Mailing Address - Phone:800-451-6245
Mailing Address - Fax:800-521-5779
Practice Address - Street 1:4600 NORTH HANLEY ROAD
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134-2715
Practice Address - Country:US
Practice Address - Phone:800-451-6245
Practice Address - Fax:800-521-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001482853336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2623735OtherOTHER ID NUMBER-COMMERCIAL NUMBER