Provider Demographics
NPI:1679616536
Name:GLOBE SELF SERVICE DRUG INCORPORATED
Entity Type:Organization
Organization Name:GLOBE SELF SERVICE DRUG INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:314-865-1024
Mailing Address - Street 1:2626 CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-3130
Mailing Address - Country:US
Mailing Address - Phone:314-865-1024
Mailing Address - Fax:314-664-7713
Practice Address - Street 1:2626 CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-3130
Practice Address - Country:US
Practice Address - Phone:314-865-1024
Practice Address - Fax:314-664-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO027785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2610992OtherNABP