Basic Information
| Provider Information | |||||||||
| NPI: | 1902865033 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHUBERT | ||||||||
| FirstName: | KARRY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24030 STABLE LN | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 655833446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9124093426 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 143 REPLACEMENT AVE | ||||||||
| Address2: | PX BLDG 487 | ||||||||
| City: | FORT LEONARD WOOD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5735961709 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2006 | ||||||||
| LastUpdateDate: | 11/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 0202012181 | VA | Y | Pharmacy Service Providers | Pharmacist | 183500000X | RPH021474 | GA | N | Pharmacy Service Providers | Pharmacist |
No ID Information.