1558443911 NPI number — ESI MAIL PHARMACY SERVICE INC

Table of content: (NPI 1558443911)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558443911 NPI number — ESI MAIL PHARMACY SERVICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESI MAIL PHARMACY SERVICE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EXPRESS SCRIPTS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558443911
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4600 NORTH HANLEY ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63134-2715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-451-6245
Provider Business Mailing Address Fax Number:
800-521-5779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4600 NORTH HANLEY ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST. LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63134-2715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-451-6245
Provider Business Practice Location Address Fax Number:
800-521-5779
Provider Enumeration Date:
10/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PEPPERS
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ASST SECRETARY
Authorized Official Telephone Number:
513-858-4916

Provider Taxonomy Codes

  • Taxonomy code: 3336M0002X , with the licence number:  2000148285 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2623735 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".