Organization · Type 2 NPI

Dierbergs Markets, Incorporated

Diabetes Educator Registered Nurse · Fenton, MO

NPI number 1538258207 Active

Practice location

450 Old Smizer Mill Rd.
Fenton, MO 63026

Fax (636) 530-3018

Specialties and licenses

Taxonomy	Code	License
Diabetes Educator Registered Nurse Primary	163WD0400X	None listed
Pharmacy	333600000X	2000158538 (MO)
Community/Retail Pharmacy	3336C0003X	None listed

Diabetes Educator Registered Nurse: Definition to come...

NPI record

NPI: 1538258207
Entity type: Organization (Type 2)
Issued: Oct 12, 2006
Last updated: Mar 16, 2021
Status: Active
Subpart: Yes of Dierbergs Markets, Incorporated

Other names

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Dierbergs Fenton Crossing Pharmacy · doing business as
Dierbergs Fenton Crossing Pharmacy · doing business as

Authorized official

Greg Guenther
Pharmacy Director
(636) 812-1472

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1538258207

Dierbergs Markets, Incorporated's National Provider Identifier is 1538258207, issued on Oct 12, 2006. The primary taxonomy on file is Diabetes Educator Registered Nurse (163WD0400X), and the practice location is in Fenton, MO. The record was last updated on Mar 16, 2021.