MEDICARE: MRS. EMILY ANN BUERSMEYER DPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13631	OK

General Provider Information

NPI Number	:	1407915770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY ANN BUERSMEYER DPH

Provider Business Mailing Address
First Line	:	8800 NW 113TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-2152
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10904 N MAY AVE STE L
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6203
Country	:	US
Telephone Number	:	405-751-2852
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	03/02/2011

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