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NPI 1033486105

NPI 1033486105 : STEVEN CHERRY RPH : OTTAWA, KS

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General NPI Number Information
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    NPI Number           |    1033486105
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN CHERRY RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/17/2011
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    Last Update Date     |    11/17/2011
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Provider Practice Location Address
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    Address Line         |    1445 S MAIN ST 
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    City                 |    OTTAWA
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    State                |    KS
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    Zip                  |    66067-3528
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    Country              |    US
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    Telephone            |    785-242-4745
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    Fax                  |    785-242-5013
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Provider Business Mailing Address
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    Address Line         |    1013 FIRETREE AVE 
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    City                 |    BALDWIN CITY
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    State                |    KS
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    Zip                  |    66006-4173
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    Country              |    US
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    Telephone            |    
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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       |    11793
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    License Number State |    KS
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