Provider Demographics
NPI:1952063919
Name:STAIGER, MELODY ELAINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:ELAINE
Last Name:STAIGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HIGHWAY K
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-6661
Mailing Address - Country:US
Mailing Address - Phone:636-379-1918
Mailing Address - Fax:
Practice Address - Street 1:2300 HIGHWAY K
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-6661
Practice Address - Country:US
Practice Address - Phone:636-379-1918
Practice Address - Fax:636-614-3242
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021030447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist