Provider Demographics
NPI:1659637221
Name:SAUS, JAMES M (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:SAUS
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 1:4094 JACOBS LNDG
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7494
Mailing Address - Country:US
Mailing Address - Phone:636-928-3579
Mailing Address - Fax:
Practice Address - Street 1:200 COSTCO WAY
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-4385
Practice Address - Country:US
Practice Address - Phone:636-970-4003
Practice Address - Fax:636-970-4024
Is Sole Proprietor?:No
Enumeration Date:2012-04-07
Last Update Date:2012-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO042184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist