Healthcare Provider Details

I. General information

NPI: 1871949602
Provider Name (Legal Business Name): KELLY CHILLARI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOSPITAL DR
COLUMBIA MO
65201-5275
US

IV. Provider business mailing address

PO BOX 2429
SMYRNA TN
37167-1719
US

V. Phone/Fax

Practice location:
  • Phone: 573-814-6000
  • Fax:
Mailing address:
  • Phone: 615-355-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number28RI03717000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: