Provider Demographics
NPI:1104571363
Name:PUREMEDS LLC
Entity type:Organization
Organization Name:PUREMEDS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAREESH KUMAR REDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:314-359-2389
Mailing Address - Street 1:659 BIG BEND RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7723
Mailing Address - Country:US
Mailing Address - Phone:636-438-5095
Mailing Address - Fax:
Practice Address - Street 1:659 BIG BEND RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-7723
Practice Address - Country:US
Practice Address - Phone:636-438-5095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy