Provider Demographics
NPI:1245515642
Name:LUEKER, ADAM (RPH)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:LUEKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 MONTE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-3445
Mailing Address - Country:US
Mailing Address - Phone:314-704-0610
Mailing Address - Fax:866-764-7627
Practice Address - Street 1:1550 S NEW FLORISSANT RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8123
Practice Address - Country:US
Practice Address - Phone:314-830-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9237183500000X
MO044124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist