Provider Demographics
NPI:1720394893
Name:SCHLOSS, KACY ELLEN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KACY
Middle Name:ELLEN
Last Name:SCHLOSS
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 1:100 EASTERN STAR CT
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-5812
Mailing Address - Country:US
Mailing Address - Phone:314-808-8182
Mailing Address - Fax:636-583-1642
Practice Address - Street 1:140 NORTHSTAR DR
Practice Address - Street 2:
Practice Address - City:HOLTS SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:65043-1123
Practice Address - Country:US
Practice Address - Phone:573-826-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010018114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist