Dr San Baban, PHARM D is a
Pharmacist based in Black Jack, Missouri. Dr San Baban is licensed to practice in Missouri (license number 2017031679) and his current practice location is
12400 Old Halls Ferry Rd, Black Jack, Missouri. He can be reached at his office (for appointments etc.) via phone at
(314) 741-8688.
NPI number for Dr San Baban is 1770194391 and his current mailing address is 12400 Old Halls Ferry Rd, Black Jack, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1770194391.
Healthcare Provider's Profile
| Full Name | Dr San Baban |
|---|
| Gender | Male |
|---|
| Speciality | Pharmacist |
|---|
| Location | 12400 Old Halls Ferry Rd, Black Jack, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1770194391
- Provider Enumeration Date: 08/17/2020
- Last Update Date: 08/17/2020
Medical Identifiers
Medical identifiers for Dr San Baban such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770194391 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | 2017031679 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr San Baban is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr San Baban, PHARM D
12400 Old Halls Ferry Rd,
Black Jack, MO 63033-4202
Ph: () - | Dr San Baban, PHARM D
12400 Old Halls Ferry Rd,
Black Jack, MO 63033-4202
Ph: (314) 741-8688 |
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