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General NPI Number Information
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NPI Number | 1942550769
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Entity Type | Individual
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Provider Name | KAMILA MICHELLE TRUITT RPH, PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 1820 S SPRINGFIELD AVE
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City | BOLIVAR
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State | MO
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Zip | 65613-2563
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Country | US
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Telephone | 417-777-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 5471 DR MARTIN LUTHER KING DR
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City | SAINT LOUIS
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State | MO
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Zip | 63112-4265
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Country | US
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Telephone | 314-367-5820
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Fax | 314-367-7010
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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 | 2012030786
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License Number State | MO
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