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General NPI Number Information
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NPI Number | 1427656693
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Entity Type | Individual
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Provider Name | JULIE MARIE MASTERS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2020
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Last Update Date | 10/11/2020
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Provider Practice Location Address
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Address Line | 1400 HARRISON ST
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City | QUINCY
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State | IL
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Zip | 62301-6706
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Country | US
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Telephone | 217-222-2930
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Fax |
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Provider Business Mailing Address
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Address Line | 1778 N 703RD LN
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City | LIBERTY
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State | IL
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Zip | 62347-4701
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Country | US
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Telephone | 217-779-3394
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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 | 2005013330
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.290274
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License Number State | IL
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