MEDICARE: ANN OEHLERT

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	CS15411	ID
2	183500000X	Pharmacist	P6360	ID

General Provider Information

NPI Number	:	1831467414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN OEHLERT

Provider Business Mailing Address
First Line	:	PO BOX 510
Second Line	:
City	:	SPIRIT LAKE
State	:	ID
Zip	:	83869-0510
Country	:	US
Telephone Number	:	208-623-8485
Fax Number	:	208-623-3400

Provider Business Practice Location Address
First Line	:	31964 N. FIFTH AVE
Second Line	:
City	:	SPIRIT LAKE
State	:	ID
Zip	:	83869
Country	:	US
Telephone Number	:	208-623-8485
Fax Number	:	208-623-3400

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

Provider Enumeration Date	:	12/09/2011
Last Update Date	:	02/16/2018

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Directions to “ ANN OEHLERT ” Practice Location

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