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General NPI Number Information
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NPI Number | 1518447580
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Entity Type | Individual
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Provider Name | MADISON MICHELLE LOEHR PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2018
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 255 NW VICTORIA DR STE B
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City | LEES SUMMIT
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State | MO
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Zip | 64086-4709
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Country | US
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Telephone | 855-937-7273
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 S ELLSWORTH RD APT 2032
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City | MESA
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State | AZ
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Zip | 85209-2804
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Country | US
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Telephone | 712-346-8597
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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 | S023416
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License Number State | AZ
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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 | 2020004497
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License Number State | MO
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