MEDICARE: DR. GETRUDE CHIMHUNGWE 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	2012026078	MO

General Provider Information

NPI Number	:	1164774881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GETRUDE CHIMHUNGWE PHARMD

Provider Business Mailing Address
First Line	:	2386 N HIGHWAY 67
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-2034
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2386 N HIGHWAY 67
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63033-2034
Country	:	US
Telephone Number	:	314-921-7700
Fax Number	:

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

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	05/06/2013

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