Provider Demographics
NPI:1538443197
Name:KEMP, JERRY C (RPH)
Entity type:Individual
Prefix:MR
First Name:JERRY
Middle Name:C
Last Name:KEMP
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 NATURAL BRIDGE RD.
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121
Mailing Address - Country:US
Mailing Address - Phone:314-381-8600
Mailing Address - Fax:314-381-6844
Practice Address - Street 1:7150 NATURAL BRIDGE RD.
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121
Practice Address - Country:US
Practice Address - Phone:314-381-8600
Practice Address - Fax:314-381-6844
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO041971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist