Provider Demographics
NPI:1285522342
Name:RAGHA, NIRALI MAYUR (RPH)
Entity type:Individual
Prefix:
First Name:NIRALI
Middle Name:MAYUR
Last Name:RAGHA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MO
Mailing Address - Zip Code:63077-1033
Mailing Address - Country:US
Mailing Address - Phone:636-629-8085
Mailing Address - Fax:636-629-8085
Practice Address - Street 1:13150 ROYAL PINES DR UNIT 6
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-2266
Practice Address - Country:US
Practice Address - Phone:760-540-5855
Practice Address - Fax:760-540-5855
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025008279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist