Healthcare Provider Details

I. General information

NPI: 1861405482
Provider Name (Legal Business Name): REBEKAH ELIZABETH GEBHARDS PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 MAIN ST
TARKIO MO
64491-1544
US

IV. Provider business mailing address

20075 STATE HIGHWAY Y
ROCK PORT MO
64482-7121
US

V. Phone/Fax

Practice location:
  • Phone: 660-736-5512
  • Fax: 660-736-4361
Mailing address:
  • Phone: 660-744-2161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12030
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2004033682
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: