Healthcare Provider Details

I. General information

NPI: 1841737582
Provider Name (Legal Business Name): ANNE C. EISENBEIS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE C. ROGERS PHARM.D.

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 EAST 24 HIGHWAY
MOBERLY MO
65270
US

IV. Provider business mailing address

5901 ABBEY LN
COLUMBIA MO
65202-4088
US

V. Phone/Fax

Practice location:
  • Phone: 660-263-6710
  • Fax: 660-263-2269
Mailing address:
  • Phone: 314-324-6886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2014037240
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: