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General NPI Number Information
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NPI Number | 1316585581
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Entity Type | Individual
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Provider Name | DEBORAH MAGOUN ROSENBAUM PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | DEBORAH.ROSENBAUM@STORES.KROGER.COM 4910 I-55 NORTH
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City | JACKSON
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State | MS
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Zip | 39211
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Country | US
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Telephone | 601-366-6554
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Fax | 601-987-8382
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Provider Business Mailing Address
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Address Line | DEBORAH.ROSENBAUM@STORES.KROGER.COM 4910 I-55 NORTH
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City | JACKSON
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State | MS
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Zip | 39211
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Country | US
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Telephone | 601-366-6554
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Fax | 601-987-8382
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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 | E-07632
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License Number State | MS
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