Individual provider · Type 1 NPI

Clark Kebodeaux, PharmD

Pharmacist · St. Louis, MO

NPI number 1669785697 Active

Practice location

4218 Lindell Blvd
St. Louis, MO 63108-2916

Call (314) 534-3829 Map

Mailing address

4588 Parkview Pl
St. Louis, MO 63110-1029

Specialties and licenses

TaxonomyCodeLicense
Pharmacist 183500000X015036 (KY)
Pharmacist Primary 183500000X2011021859 (MO)

Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…

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About NPI 1669785697

Clark Kebodeaux, PharmD's National Provider Identifier is 1669785697, issued on Jul 19, 2010. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in St. Louis, MO. The record was last updated on Aug 10, 2011.