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NPI Code Detail

MEDICARE: JACQUELINE ELIZABETH VOGEL PHARMD

MEDICARE:   JACQUELINE ELIZABETH VOGEL  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
1183500000XPharmacist051296185IL
2183500000XPharmacist2012031235MO

General Provider Information

NPI Number : 1366873283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE ELIZABETH VOGEL PHARMD
Provider Business Mailing Address
First Line : 9012 CORAL DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63123-4502
Country : US
Telephone Number : 618-830-2201
Fax Number :
Provider Business Practice Location Address
First Line : 102 W VANDALIA ST
Second Line :
City : EDWARDSVILLE
State : IL
Zip : 62025-1910
Country : US
Telephone Number : 618-692-7251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2013
Last Update Date : 12/02/2013

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Directions to “ JACQUELINE ELIZABETH VOGEL PHARMD” Practice Location

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