Provider Demographics
NPI:1215423447
Name:ELAM, BRIGID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRIGID
Middle Name:
Last Name:ELAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 W GREENSMITH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-8240
Mailing Address - Country:US
Mailing Address - Phone:314-315-3565
Mailing Address - Fax:
Practice Address - Street 1:11550 PAGE SERVICE DR STE 101B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3531
Practice Address - Country:US
Practice Address - Phone:314-344-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009004992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist