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NPI Code Detail

MEDICARE: ANGELA M BROOKS RPH

MEDICARE: ANGELA M BROOKS RPH
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
1183500000XPharmacist2004033687MO
2183500000XPharmacist051-293025IL

General Provider Information

NPI Number : 1811271612
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA M BROOKS RPH
Provider Business Mailing Address
First Line : 120 S BISHOP AVE
Second Line :
City : ROLLA
State : MO
Zip : 65401-4215
Country : US
Telephone Number : 573-426-3338
Fax Number : 573-426-3168
Provider Business Practice Location Address
First Line : 120 S BISHOP AVE
Second Line :
City : ROLLA
State : MO
Zip : 65401-4215
Country : US
Telephone Number : 573-426-3338
Fax Number : 573-426-3168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2011
Last Update Date : 09/28/2011

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Directions to “ ANGELA M BROOKS RPH” Practice Location

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