Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keith Alan Wallace, BSPHARM

Individual provider Pharmacist · NPI 1750408795

Keith Alan Wallace, BSPHARM is a Pharmacist in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2007.

Licensed in
MO
In the registry since
2007

Practice location Address checks out

11643 Lilburn Park Rd
Saint Louis, MO 63146-3535
Phone: (314) 995-6843
Fax: (888) 916-0877
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 2001019315 (MO)

Record details

NPI number1750408795
Entity typeIndividual (Type 1)
GenderMale
Credentials BSPHARM
Sole proprietorNo
NPI enumeratedMarch 23, 2007
Last updated in NPPESJanuary 14, 2011
Mailing address5 Woodland Ridge Ct, Saint Peters, MO 63376-1788

Other providers in Saint Louis