MEDICARE: STEPHANIE MARIE THIMM 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	1-14853	KS
2	183500000X	Pharmacist	2010025229	MO

General Provider Information

NPI Number	:	1285066175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MARIE THIMM PHARMD

Provider Business Mailing Address
First Line	:	2740 N REGENCY PARK
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4527
Country	:	US
Telephone Number	:	316-681-2181
Fax Number	:	316-681-0277

Provider Business Practice Location Address
First Line	:	2740 N REGENCY PARK
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4527
Country	:	US
Telephone Number	:	316-681-2181
Fax Number	:	316-681-0277

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

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	08/02/2013

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Directions to “ STEPHANIE MARIE THIMM PHARMD” Practice Location

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