Provider Demographics
NPI:1801505318
Name:TROUP, CASSIDY (PHARMD, MS)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:TROUP
Suffix:
Gender:F
Credentials:PHARMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4753 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63111-1717
Mailing Address - Country:US
Mailing Address - Phone:309-360-6273
Mailing Address - Fax:
Practice Address - Street 1:3915 WATSON RD STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1251
Practice Address - Country:US
Practice Address - Phone:888-504-2621
Practice Address - Fax:833-427-1469
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022028391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist