Organization · Type 2 NPI

SSM Health Care St. Louis

Community/Retail Pharmacy · O Fallon, MO

NPI number 1639928690 Active

Practice location

301 Caledonia Pkwy Ste 110
O Fallon, MO 63368-6690

Fax (636) 202-6811

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

Other community/retail pharmacy providers in O Fallon

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NPI record

NPI: 1639928690
Entity type: Organization (Type 2)
Issued: May 14, 2024
Last updated: May 19, 2025
Status: Active
Subpart: Yes of SSM Health Care St. Louis

Other names

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SSM Health Prescription Center · doing business as
SSM Health Prescription Center · doing business as

Authorized official

Jeremy Fotheringham
Regional President
(314) 994-7930

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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 1639928690

SSM Health Care St. Louis's National Provider Identifier is 1639928690, issued on May 14, 2024. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in O Fallon, MO. The record was last updated on May 19, 2025.