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NPI Code Detail

MEDICARE: MRS. ELSIE M. SIEGMANN R.PH.

MEDICARE: MRS. ELSIE M. SIEGMANN R.PH.
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
1183500000XPharmacist042493MO
2183500000XPharmacist8686OK

General Provider Information

NPI Number : 1417230343
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELSIE M. SIEGMANN R.PH.
Provider Business Mailing Address
First Line : 2640 E SUNSHINE ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-2045
Country : US
Telephone Number : 417-885-1274
Fax Number : 417-883-7089
Provider Business Practice Location Address
First Line : 2640 E SUNSHINE ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-2045
Country : US
Telephone Number : 417-885-1274
Fax Number : 417-883-7089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2011
Last Update Date : 09/27/2011

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