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General NPI Number Information
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NPI Number | 1205613387
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Entity Type | Individual
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Provider Name | KIMBERLY EKERN RPH
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Gender | Female
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 1601 OLD 63 S
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City | COLUMBIA
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State | MO
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Zip | 65201-8412
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Country | US
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Telephone | 573-884-2653
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Fax | 573-884-9434
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Provider Business Mailing Address
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Address Line | 13254 AUDRAIN ROAD 913
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City | MEXICO
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State | MO
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Zip | 65265-6550
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Country | US
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Telephone | 573-721-3300
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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 | 044920
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License Number State | MO
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