Healthcare Provider Details

I. General information

NPI: 1932912672
Provider Name (Legal Business Name): CHRISTINE DELORES RHODES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 STATE HIGHWAY 25 S
BLOOMFIELD MO
63825-9567
US

IV. Provider business mailing address

16670 COUNTY ROAD 511
DEXTER MO
63841-9733
US

V. Phone/Fax

Practice location:
  • Phone: 573-568-2643
  • Fax: 573-568-3281
Mailing address:
  • Phone: 573-281-6160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2005030409
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: