1699080119 NPI number — DR. KEZIA J UHRICH PHARMD

Table of content: DR. KEZIA J UHRICH PHARMD (NPI 1699080119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699080119 NPI number — DR. KEZIA J UHRICH PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UHRICH
Provider First Name:
KEZIA
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHWIETERMAN
Provider Other First Name:
KEZIA
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699080119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 CENTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLEY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67748-1711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-672-4727
Provider Business Mailing Address Fax Number:
785-672-4757

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 CENTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLEY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67748-1711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-672-4727
Provider Business Practice Location Address Fax Number:
785-672-4757
Provider Enumeration Date:
08/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  1-14161 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1-14161 . This is a "KANSAS PHARMACIST LISCENSE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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