Healthcare Provider Details

I. General information

NPI: 1063939379
Provider Name (Legal Business Name): CARLEE BAUMANN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1526 LINCOLN ST
CONCORDIA KS
66901-4830
US

IV. Provider business mailing address

1526 LINCOLN ST
CONCORDIA KS
66901-4830
US

V. Phone/Fax

Practice location:
  • Phone: 785-243-1212
  • Fax:
Mailing address:
  • Phone: 785-243-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-102892
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: