Basic Information
| Provider Information | |||||||||
| NPI: | 1003014135 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAFFERTY | ||||||||
| FirstName: | PAT | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4588 PARKVIEW PL | ||||||||
| Address2: | ST. LOUIS COLLEGE OF PHARMACY | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631101029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144468538 | ||||||||
| FaxNumber: | 3144468386 | ||||||||
| Practice Location | |||||||||
| Address1: | 4588 PARKVIEW PL | ||||||||
| Address2: | ST. LOUIS COLLEGE OF PHARMACY | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631101029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144468538 | ||||||||
| FaxNumber: | 3144468386 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 07/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 043930 | MO | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.