Provider Demographics
NPI:1053853598
Name:ARGANA, MARY ELLEN (RPH)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELLEN
Last Name:ARGANA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:MO
Mailing Address - Zip Code:63020-1709
Mailing Address - Country:US
Mailing Address - Phone:636-586-2202
Mailing Address - Fax:636-337-5533
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-1709
Practice Address - Country:US
Practice Address - Phone:636-586-2202
Practice Address - Fax:636-337-5533
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist