Provider Demographics
NPI:1942998778
Name:KAMENJU, GLADWELL WANJIRU (PHARMD)
Entity Type:Individual
Prefix:
First Name:GLADWELL
Middle Name:WANJIRU
Last Name:KAMENJU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:GLADWELL
Other - Middle Name:WANJIRU
Other - Last Name:KANYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7450 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3931
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7450 HAMPTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-3931
Practice Address - Country:US
Practice Address - Phone:314-832-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.305469183500000X
MO2022037521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist