Provider Demographics
NPI:1811619257
Name:TINT, NOEL DENNIS
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:DENNIS
Last Name:TINT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 S KINGSHIGHWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-1817
Mailing Address - Country:US
Mailing Address - Phone:314-773-1384
Mailing Address - Fax:314-773-1971
Practice Address - Street 1:3822 S KINGSHIGHWAY BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1817
Practice Address - Country:US
Practice Address - Phone:314-773-1384
Practice Address - Fax:314-773-1971
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022036742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist