Healthcare Provider Details

I. General information

NPI: 1801081674
Provider Name (Legal Business Name): KAREN MARIE SHUBERT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 E INDUSTRIAL PARK RD UNIT 1
MURPHYSBORO IL
62966-3947
US

IV. Provider business mailing address

550 E INDUSTRIAL PARK RD UNIT 1
MURPHYSBORO IL
62966-3947
US

V. Phone/Fax

Practice location:
  • Phone: 618-687-9454
  • Fax:
Mailing address:
  • Phone: 618-687-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number013571
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number013571
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051289523
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051289523
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: