Provider Demographics
NPI:1649756842
Name:SCHWEPPE, ALPHA JANE
Entity Type:Individual
Prefix:
First Name:ALPHA
Middle Name:JANE
Last Name:SCHWEPPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 STARLIT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-2245
Mailing Address - Country:US
Mailing Address - Phone:314-892-8862
Mailing Address - Fax:
Practice Address - Street 1:20 GRAVOIS DILLON PLZ
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2478
Practice Address - Country:US
Practice Address - Phone:636-677-0430
Practice Address - Fax:636-677-2345
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
MO028173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist