Healthcare Provider Details

I. General information

NPI: 1104733476
Provider Name (Legal Business Name): BARBARA ANN WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 HIGHWAY T
MARTHASVILLE MO
63357-2078
US

IV. Provider business mailing address

3435 HIGHWAY T
MARTHASVILLE MO
63357-2078
US

V. Phone/Fax

Practice location:
  • Phone: 636-293-4134
  • Fax:
Mailing address:
  • Phone: 636-293-4134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number041256
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: