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NPI 1205582335

NPI 1205582335 : CORRINA SAMBS PHARMD : WAUPACA, WI

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General NPI Number Information
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    NPI Number           |    1205582335
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    Entity Type          |    Individual 
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    Provider Name        |    CORRINA SAMBS PHARMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/28/2022
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    Last Update Date     |    04/16/2022
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Provider Practice Location Address
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    Address Line         |    115 N WESTERN AVE 
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    City                 |    WAUPACA
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    State                |    WI
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    Zip                  |    54981-2201
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    Country              |    US
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    Telephone            |    715-256-0400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6080 DEER RD 
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    City                 |    AMHERST
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    State                |    WI
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    Zip                  |    54406-8959
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    Country              |    US
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    Telephone            |    920-379-7010
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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        |    1835P0018X
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    Taxonomy Name        |    Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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    License Number       |    21051-40
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    License Number State |    WI
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