Provider Demographics
NPI:1629695838
Name:SSM-SLUH, INC.
Entity Type:Organization
Organization Name:SSM-SLUH, INC.
Other - Org Name:SSM HEALTH PHARMACY AT SAINT LOUIS UNIVERSITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P. PHARMACY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:314-989-2588
Mailing Address - Street 1:1225 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1016
Mailing Address - Country:US
Mailing Address - Phone:314-268-7153
Mailing Address - Fax:314-268-5166
Practice Address - Street 1:1225 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1016
Practice Address - Country:US
Practice Address - Phone:314-268-7153
Practice Address - Fax:314-268-5166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-03
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy