MEDICARE: ELIZABETH PYTLINSKI 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
1	183500000X	Pharmacist	2013026227	MO

General Provider Information

NPI Number	:	1679021802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PYTLINSKI PHARM.D.

Provider Business Mailing Address
First Line	:	776 HARVARD AVE
Second Line	:
City	:	UNIVERSITY CITY
State	:	MO
Zip	:	63130-3134
Country	:	US
Telephone Number	:	314-809-4387
Fax Number	:

Provider Business Practice Location Address
First Line	:	12595 OLIVE BLVD
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-6311
Country	:	US
Telephone Number	:	314-542-2194
Fax Number	:	636-530-3015

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

Provider Enumeration Date	:	09/16/2016
Last Update Date	:	09/16/2016

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