MEDICARE: DEBORAH BILLING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	040963	MO

General Provider Information

NPI Number	:	1023457041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH BILLING

Provider Business Mailing Address
First Line	:	1820 WENTZVILLE PKWY
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-3817
Country	:	US
Telephone Number	:	636-887-3317
Fax Number	:	636-530-3006

Provider Business Practice Location Address
First Line	:	1820 WENTZVILLE PKWY
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-3817
Country	:	US
Telephone Number	:	636-887-3317
Fax Number	:	636-530-3006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	06/24/2013

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Directions to “ DEBORAH BILLING ” Practice Location

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