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NPI Code Detail

MEDICARE: DR. BONITA TORBERT PHARM.D.

MEDICARE: DR. BONITA TORBERT PHARM.D.
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
1183500000XPharmacist2004009051MO

General Provider Information

NPI Number : 1124302641
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BONITA TORBERT PHARM.D.
Provider Business Mailing Address
First Line : 7501 OLIVE BLVD
Second Line :
City : UNIVERSITY CITY
State : MO
Zip : 63130-1602
Country : US
Telephone Number : 314-725-6133
Fax Number :
Provider Business Practice Location Address
First Line : 7501 OLIVE BLVD
Second Line :
City : UNIVERSITY CITY
State : MO
Zip : 63130-1602
Country : US
Telephone Number : 314-725-6133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2011
Last Update Date : 10/03/2011

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