Provider Demographics
NPI:1881419893
Name:BAST, CAROLYN HOFFMEYER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:HOFFMEYER
Last Name:BAST
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:ROSE
Other - Last Name:HOFFMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4600 N HANLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63134-2715
Mailing Address - Country:US
Mailing Address - Phone:855-793-7737
Mailing Address - Fax:877-304-9402
Practice Address - Street 1:4600 N HANLEY RD STE B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134-2715
Practice Address - Country:US
Practice Address - Phone:855-793-7737
Practice Address - Fax:877-304-9402
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009023439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist