Healthcare Provider Details

I. General information

NPI: 1679187611
Provider Name (Legal Business Name): ALLISON JO BIEBERLE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 OHIO ST
AUGUSTA KS
67010-2189
US

IV. Provider business mailing address

700 N MAIN ST
EL DORADO KS
67042-4526
US

V. Phone/Fax

Practice location:
  • Phone: 316-775-5456
  • Fax: 316-775-4108
Mailing address:
  • Phone: 316-321-0318
  • Fax: 316-321-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number1-100809
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: