Provider Demographics
NPI:1912541228
Name:ACARIAHEALTH PHARMACY 13 INC
Entity Type:Organization
Organization Name:ACARIAHEALTH PHARMACY 13 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:CICCOLELLA-KAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-511-5144
Mailing Address - Street 1:PO BOX 956780
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-6780
Mailing Address - Country:US
Mailing Address - Phone:855-422-2742
Mailing Address - Fax:877-801-6091
Practice Address - Street 1:3302 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-3102
Practice Address - Country:US
Practice Address - Phone:800-511-5144
Practice Address - Fax:877-541-1503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy