MISSOURI LTC PHARMACY LLC NPI 1134668445

NPI Information

  • NPI: 1134668445
  • Provider Name: MISSOURI LTC PHARMACY LLC
  • Classification: Pharmacy - 3336L0003X
  • Specialization: Long Term Care Pharmacy
  • Entity Type: Organization
  • Doing Business As: INFINIUM PHARMACY
  • Address: 1617 MANUFACTURERS DR
    FENTON, MO
    ZIP 63026
  • Phone: (314) 690-4500

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NPI Details

MISSOURI LTC PHARMACY LLC is a long term care pharmacy pharmacy in Fenton, MO. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. MISSOURI LTC PHARMACY LLC NPI is 1134668445. The provider is registered as an organization entity type.
The provider Is Doing Business As Infinium Pharmacy.

The provider's business location address is:

1617 MANUFACTURERS DR
FENTON, MO
ZIP 63026-838
Phone: (314) 690-4500
Fax: (314) 690-4502

The provider's authorized official is Janice Ceriotti .
The authorized official title is Chief Operating Officer and has the following contact phone number (314) 690-4500.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose (HCPCS:0012A)
  • Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; first dose (HCPCS:0011A)

The enumeration date for this NPI number is 2/20/2017 and was last updated on 9/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12167982OTHERPK
2314944407MEDICAIDARKANSAS
3600043834MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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