Provider Demographics
NPI:1194506329
Name:QUEEN CITY PHARMACIES, LLC
Entity type:Organization
Organization Name:QUEEN CITY PHARMACIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-497-9311
Mailing Address - Street 1:755 S NEW BALLAS RD STE 260
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8744
Mailing Address - Country:US
Mailing Address - Phone:314-497-9311
Mailing Address - Fax:
Practice Address - Street 1:1474 N BOONVILLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-1806
Practice Address - Country:US
Practice Address - Phone:417-869-1866
Practice Address - Fax:417-869-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy