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NPI Code Detail

MEDICARE: RAYMOND H. WILBERS, INC

MEDICARE: RAYMOND H. WILBERS, INC
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
1305R00000XPreferred Provider Organization102389MO

General Provider Information

NPI Number : 1881765105
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAYMOND H. WILBERS, INC
Provider Business Mailing Address
First Line : 111 E 1ST ST
Second Line :
City : MONTGOMERY CITY
State : MO
Zip : 63361-2550
Country : US
Telephone Number : 573-564-3214
Fax Number : 573-564-3216
Provider Business Practice Location Address
First Line : 111 E 1ST ST
Second Line :
City : MONTGOMERY CITY
State : MO
Zip : 63361-2550
Country : US
Telephone Number : 573-564-3214
Fax Number : 573-564-3216
Authorized Official
Title or Position : FNP
Name : LONDA Y SWOBODA
Credential : FNP,BSN,MSN
Telephone Number : 573-564-3214
Provider Enumeration Date : 11/10/2006
Last Update Date : 01/15/2008

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Directions to “RAYMOND H. WILBERS, INC ” Practice Location

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