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NPI Code Detail

MEDICARE: STEPHANIE ANN MATILE

MEDICARE:   STEPHANIE ANN MATILE
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
1183500000XPharmacist1-12885KS

General Provider Information

NPI Number : 1174806467
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ANN MATILE
Provider Business Mailing Address
First Line : 545 E SANTA FE ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-3462
Country : US
Telephone Number : 913-393-2757
Fax Number : 913-393-2754
Provider Business Practice Location Address
First Line : 545 E SANTA FE ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-3462
Country : US
Telephone Number : 913-393-2757
Fax Number : 913-393-2754
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2011
Last Update Date : 09/22/2011

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Directions to “ STEPHANIE ANN MATILE ” Practice Location

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