Provider Demographics
NPI:1447906771
Name:SEFORA ENTERPRISES LLC
Entity type:Organization
Organization Name:SEFORA ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNEETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-373-7966
Mailing Address - Street 1:6 WATERFRONT GRV
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4816
Mailing Address - Country:US
Mailing Address - Phone:636-373-7966
Mailing Address - Fax:
Practice Address - Street 1:5819 S LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-6948
Practice Address - Country:US
Practice Address - Phone:636-373-7966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy