Ellis R Odom is a Pharmacist in Poplar Bluff, Missouri. Ellis R Odom practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Ellis R Odom is 1457330219. The last update date is 2007-07-08.
Ellis R Odom's current location address is Po Box 220, Poplar Bluff, Missouri. You can contact this provider via phone number 5736862411 and fax number 5736868452. The mailing address for Ellis R Odom is Po Box 220, Poplar Bluff, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ellis R Odom |
|---|---|
| Address | Po Box 220, Poplar Bluff, Missouri |
| Phone Number | 5736862411 |
| Fax Number | 5736868452 |
| Sole Proprietor | X |
| Credentials | RPH |
NPI Number Detail
| NPI Number | 1457330219 |
|---|---|
| Provider Enumeration Date | 2006-01-11 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 220 |
|---|---|
| City | Poplar Bluff |
| State | Missouri (MO) |
| Post Code | 63902 |
| Phone Number | 5736862411 |
| Fax Number | 5736868452 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 42673 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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What is the unique identifier code issued to Ellis R Odom by the Centers for Medicare & Medicaid Services?
The Ellis R Odom has been assigned the NPI (National Provider Identifier) 1457330219. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Ellis R Odom located?
The Ellis R Odom is located at Po Box 220, Poplar Bluff, MO 63902.
What is the Ellis R Odom's area of specialization and corresponding taxonomy classification?
The Ellis R Odom's specialty field is Pharmacist, and it falls under the taxonomy code 183500000X, which categorizes healthcare providers based on their specialties.
On what date was the 1457330219 assigned to Ellis R Odom?
The Ellis R Odom was issued its 1457330219 on 2006-01-11, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Ellis R Odom most recently updated or revised?
The information pertaining to Ellis R Odom, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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