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General NPI Number Information
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NPI Number | 1225708472
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Entity Type | Individual
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Provider Name | JULIE DEIBEL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/19/2021
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Last Update Date | 09/19/2021
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Provider Practice Location Address
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Address Line | 3550 MCKELVEY RD STE 100B
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City | BRIDGETON
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State | MO
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Zip | 63044-2527
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Country | US
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Telephone | 314-218-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 20 RIVERWOOD ESTATES BLVD
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City | FLORISSANT
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State | MO
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Zip | 63031-6528
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Country | US
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Telephone | 314-591-8639
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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 | 2021038162
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License Number State | MO
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