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NPI Code Detail

MEDICARE: CRYSTAL D OBERING PHARM.D.

MEDICARE: CRYSTAL D OBERING 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
1183500000XPharmacist1997IA
2183500000XPharmacist117764-4MN
3183500000XPharmacist2005022608MO

General Provider Information

NPI Number : 1265425847
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL D OBERING PHARM.D.
Provider Business Mailing Address
First Line : 4734 OAK ST
Second Line : APT 1241
City : KANSAS CITY
State : MO
Zip : 64112-2272
Country : US
Telephone Number : 816-531-2758
Fax Number :
Provider Business Practice Location Address
First Line : 4801 E LINWOOD BLVD
Second Line : DEPARTMENT OF RESEARCH (151)
City : KANSAS CITY
State : MO
Zip : 64128-2226
Country : US
Telephone Number : 816-861-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 07/08/2007

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