MEDICARE: DR. LORIE ANN STEUBER 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	1835G0303X	Geriatric Pharmacist	PD10297	AR
2	1835N1003X	Nutrition Support Pharmacist	PD10297	AR
3	1835P1200X	Pharmacotherapy Pharmacist	PD10297	AR
4	183500000X	Pharmacist	TX40143	TX
5	183500000X	Pharmacist	PD10297	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PD10297	OTHER	AR	PHARMACIST LICENSE
2	TX40143	OTHER	TX	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1902971229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORIE ANN STEUBER PHARM.D.

Provider Business Mailing Address
First Line	:	1105 S TULSA AVE
Second Line	:
City	:	RUSSELLVILLE
State	:	AR
Zip	:	72801-5646
Country	:	US
Telephone Number	:	479-264-0070
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 N CHURCH ST
Second Line	:
City	:	ATKINS
State	:	AR
Zip	:	72823-4149
Country	:	US
Telephone Number	:	479-641-7878
Fax Number	:

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	06/23/2009

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