Provider Demographics
NPI:1730521139
Name:GRANT, STEVE ALAN JR (PHARM D)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:ALAN
Last Name:GRANT
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 LACKLAND RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-5458
Mailing Address - Country:US
Mailing Address - Phone:314-429-4636
Mailing Address - Fax:314-429-8664
Practice Address - Street 1:9320 LACKLAND RD
Practice Address - Street 2:
Practice Address - City:OVERLAND
Practice Address - State:MO
Practice Address - Zip Code:63114-5458
Practice Address - Country:US
Practice Address - Phone:314-429-4636
Practice Address - Fax:314-429-8664
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17500183500000X
MO2019046068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist