BRANDON GLEN ELDRIDGE (NPI# 1124258058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124258058 |
| Entity Type | Individual |
| Full Name | BRANDON GLEN ELDRIDGE |
| Credential | PHARM.D. |
| Practice Address |
1504 S Grand Blvd Saint Louis MO 63104-1304 |
| Practice Telephone | 3145353334 |
| Practice Fax Number | 3145353337 |
| Mailing Telephone | 3145353334 |
| Mailing Fax Number | 3145353337 |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2015-09-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 051.294668 | IL | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 2009020986 | MO | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 600447627 | 05 |
| Street Address |
1504 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811011505 | Hopewell Center | Clinic/Center | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2007-03-19 |
| 1730535667 | Hopewell Center | Clinic/Center | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2016-05-10 |
| 1750513156 | Alma A Grimes | Social Worker | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2009-08-18 |
| 1811143845 | Hopewell Center | Community/Behavioral Health | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2008-08-11 |
| 1548459605 | Stacie Robyn Bryant | Social Worker | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2007-10-15 |
| 1184748873 | Hopewell Center | Case Management | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2007-03-19 |
| 1992829683 | Hopewell Center | Community/Behavioral Health | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2007-03-19 |
| 1457475147 | Hopewell Center | Clinic/Center | 1504 S Grand Blvd, Saint Louis, MO 63104-1304 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | 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, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959736 | Andrea Williams | Pharmacist | 13231 Windbrooke Ln, Saint Louis, MO 63146-2221 | 2020-10-09 |
| 1417564196 | Barbara Rodgers | Pharmacist | 4700 N Hanley Rd Ste 256, Saint Louis, MO 63134-2700 | 2020-09-28 |
| 1396358339 | Michael A Heltzel | Pharmacist | 630 Emerson Rd Apt 307, Saint Louis, MO 63141-6764 | 2020-08-28 |
| 1295345866 | Elyar Gasanli | Pharmacist | 159 Lindbergh Place Dr, Saint Louis, MO 63146-5902 | 2020-08-07 |
| 1063039360 | Brad Collins | Pharmacist | 4240 Duncan Ave Ste 200, Saint Louis, MO 63110-1123 | 2020-07-02 |
| 1932720182 | Thomas Valiaparampil | Pharmacist | 7328 Cheshire Ln, Saint Louis, MO 63123-2125 | 2020-04-29 |
| 1467080945 | Ehikhuemhen Enaholo | Pharmacist | 5132 Waterman Blvd Apt 209, Saint Louis, MO 63108-1137 | 2020-03-30 |
| 1700425204 | Mena Khaled | Pharmacist | 9031 Big Chief Dr, Saint Louis, MO 63123-6605 | 2019-12-31 |
| 1952964652 | Almir Muharemovic | Pharmacist | 1205 Mangrove Ln Apt 6, Saint Louis, MO 63125-5631 | 2019-04-17 |
| 1215496518 | Ryan Freund | Pharmacist | 1861 Craig Park Ct, Saint Louis, MO 63146-4122 | 2019-03-16 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.