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General NPI Number Information
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NPI Number | 1689923328
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Entity Type | Individual
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Provider Name | DEBORAH A BAUMANN R.PH.
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Gender | Female
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 1117 MAIN ST
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City | IMPERIAL
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State | MO
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Zip | 63052-2323
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Country | US
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Telephone | 636-464-1100
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Fax | 636-464-1106
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Provider Business Mailing Address
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Address Line | 3538 SORREL TREE LANE
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City | SAINT LOUIS
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State | MO
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Zip | 63129-2952
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Country | US
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Telephone |
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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 | 0029116
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License Number State | MO
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