Provider Demographics
NPI:1457560807
Name:BELL, VIVIAN LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:LYNN
Last Name:BELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1738
Mailing Address - Country:US
Mailing Address - Phone:314-368-5378
Mailing Address - Fax:314-877-6152
Practice Address - Street 1:5300 ARSENAL ST
Practice Address - Street 2:PHARMACY DEPT B-139
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1463
Practice Address - Country:US
Practice Address - Phone:314-877-6104
Practice Address - Fax:314-877-6152
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27745183500000X
MO0415331835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric