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General NPI Number Information
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NPI Number | 1033472972
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Entity Type | Individual
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Provider Name | TIMOTHY EUGENE WEST PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 1100 S SPRINGFIELD AVE
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City | BOLIVAR
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State | MO
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Zip | 65613-2512
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Country | US
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Telephone | 417-326-2416
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Fax |
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Provider Business Mailing Address
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Address Line | 4432 S 55TH RD
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City | FAIR PLAY
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State | MO
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Zip | 65649-9317
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Country | US
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Telephone | 417-694-6524
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2006021570
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License Number State | MO
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