DIERBERGS TOWN CENTER PHARMACY NPI 1710359484

NPI Information

  • NPI: 1710359484
  • Provider Name: DIERBERGS TOWN CENTER PHARMACY
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Address: 2460 TAYLOR ROAD
    WILDWOOD, MO
    ZIP 63040
  • Phone: (636) 458-7450

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NPI Details

DIERBERGS TOWN CENTER PHARMACY is a pharmacy in Wildwood, MO. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. DIERBERGS TOWN CENTER PHARMACY NPI is 1710359484. The provider is registered as an organization entity type.

The provider's business location address is:

2460 TAYLOR ROAD
WILDWOOD, MO
ZIP 63040
Phone: (636) 458-7450

The provider's authorized official is Brenda Mcdaniel .
The authorized official title is Staff Pharmacist and has the following contact phone number (636) 458-7450.

The enumeration date for this NPI number is 10/21/2015 and was last updated on 10/21/2015.

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
1333600000XPharmacy2003031656MISSOURIYes

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
1606120103MEDICAIDMISSOURI

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: 11/21/2025

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