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General NPI Number Information
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NPI Number | 1558779397
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Entity Type | Individual
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Provider Name | SHARIN RUDDER PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 205 E NIFONG BLVD DEPTARTMENT 6
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City | COLUMBIA
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State | MO
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Zip | 65203-3760
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Country | US
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Telephone | 573-422-2951
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Fax | 573-442-6541
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Provider Business Mailing Address
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Address Line | 405 E NIFONG BLVD
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City | COLUMBIA
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State | MO
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Zip | 65201-3708
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Country | US
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Telephone | 573-442-8616
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Fax | 573-442-8652
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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 | 2010038520
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License Number State | MO
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