MEDICARE: DR. AMANDA CHRISTINE BAEBLER PHARMD

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	2006025357	MO

General Provider Information

NPI Number	:	1093039752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA CHRISTINE BAEBLER PHARMD

Provider Business Mailing Address
First Line	:	3182 WILLOW BEND DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-6538
Country	:	US
Telephone Number	:	618-830-0417
Fax Number	:

Provider Business Practice Location Address
First Line	:	11978 SAINT CHARLES ROCK RD
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2636
Country	:	US
Telephone Number	:	314-291-2290
Fax Number	:

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

Provider Enumeration Date	:	03/23/2010
Last Update Date	:	03/23/2010

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