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General NPI Number Information
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NPI Number | 1518315977
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE ODENS PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 1323 BIA ROUTE 4
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City | FORT THOMPSON
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State | SD
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Zip | 57339
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Country | US
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Telephone | 605-245-1554
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Fax | 605-245-2384
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Provider Business Mailing Address
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Address Line | PO BOX 200
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City | FORT THOMPSON
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State | SD
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Zip | 57339-0200
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Country | US
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Telephone | 605-245-1554
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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 | 5903
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License Number State | SD
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