Provider Demographics
NPI:1871203513
Name:O'DELL, WENDY AMELIA (PHARMD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:AMELIA
Last Name:O'DELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:AMELIA
Other - Last Name:DODD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1000 CROSSROADS PL
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-2234
Mailing Address - Country:US
Mailing Address - Phone:636-376-4785
Mailing Address - Fax:636-376-0714
Practice Address - Street 1:1000 CROSSROADS PL
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2234
Practice Address - Country:US
Practice Address - Phone:636-376-4785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022047187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2022047187OtherPHARMACIST LICENSE