Healthcare Provider Details

I. General information

NPI: 1295251742
Provider Name (Legal Business Name): RACHEL KAUFFMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 S. PARK ST.
EL DORADO SPRINGS MO
64744
US

IV. Provider business mailing address

1403 S. PARK ST.
EL DORADO SPRINGS MO
64744
US

V. Phone/Fax

Practice location:
  • Phone: 417-876-2511
  • Fax:
Mailing address:
  • Phone: 417-876-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2017028095
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: