Provider Demographics
NPI:1215323472
Name:WORLEY, DARREN (RPH)
Entity type:Individual
Prefix:MR
First Name:DARREN
Middle Name:
Last Name:WORLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 KATIE DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IL
Mailing Address - Zip Code:62298-1876
Mailing Address - Country:US
Mailing Address - Phone:618-980-3250
Mailing Address - Fax:
Practice Address - Street 1:11134 LINDBERGH BUSINESS CT STE D
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7838
Practice Address - Country:US
Practice Address - Phone:866-451-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001030151183500000X
IL051.288733183500000X
ARPD12980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist