ANGELA DAWN IBAVIOSA (NPI# 1134611510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134611510 |
| Entity Type | Individual |
| Full Name | ANGELA DAWN IBAVIOSA |
| Credential | R.PH. |
| Practice Address |
Parkland Health Mart 617 N. Cowling Ste G Desloge MO 63601 |
| Practice Telephone | 5734316677 |
| Mailing Telephone | 5734316677 |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 043721 | MO | Pharmacy Service Providers |
| Street Address |
PARKLAND HEALTH MART 617 N. COWLING STE G |
| City | DESLOGE |
| State | MO |
| Zip Code | 63601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881101376 | Julie Brischle | Dietitian, Registered | 1025 W. Main Street, P.o. Box 367, Park Hills, MO 63601 | 2018-01-05 |
| 1962810770 | Anns Place | Assisted Living Facility | 351 Keith Street, Park Hills, MO 63601 | 2014-07-24 |
| 1770995474 | Richard Barton | Physical Therapist | 1301 N. Saint Joe Dr., Park Hills, MO 63601 | 2014-05-29 |
| 1871927350 | Marcella Darlynn Williams | Occupational Therapist | 800 Brim Street, Desloge, MO 63601 | 2013-09-03 |
| 1356773287 | Mckenzie Lee Kaughman | Occupational Therapy Assistant | 801 Brim Street, Desloge, MO 63601 | 2013-08-02 |
| 1720292022 | Dwayne Patrick Smith | Physical Therapy Assistant | 1103 Koen Creek Ct. Apt. A, Park Hills, MO 63601 | 2007-05-09 |
| 1710078324 | Martha A Mcmurry | Counselor | 512 East Main St., Park Hills, MO 63601 | 2006-09-27 |
| 1083184667 | Scarlet Barron | General Practice | 223 W. Main St., Park Hills, MO 63601 | 2018-11-27 |
| 1104175090 | Jon Lee Clauser | Physical Therapy Assistant | 801 Brim St, Deslodge, MO 63601 | 2012-09-06 |
| 1528211182 | East Missouri Action Agency, Inc. | Clinic/Center | 403 Parkway Drive, Park Hills, MO 63601 | 2008-10-28 |
| Find all providers in zip 63601 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| 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 modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619306826 | Amber Pashia | Pharmacist | 617 N Cowling St, Ste. G, Desloge, MO 63601-3119 | 2013-11-07 |
| 1568063584 | Nicholas Joseph Dupont | Pharmacist | 407 N State St, Desloge, MO 63601-3053 | 2020-11-05 |
| 1548860158 | Holly Russell | Pharmacist | 407 N State St, Desloge, MO 63601-3053 | 2020-11-01 |
| 1942813621 | Rachel Anne Meredith | Pharmacist | 1142 N Desloge Dr, Desloge, MO 63601-2937 | 2020-08-24 |
| 1528559564 | Cynthia Pikey | Pharmacist | 407 N State St, Desloge, MO 63601-3053 | 2018-05-25 |
| 1043602717 | Lauren Williams | Pharmacist | 1142 N Desloge Dr, Desloge, MO 63601-2937 | 2015-03-04 |
| 1639561319 | Cara Shepard-propst | Pharmacist | 1142 N Desloge Dr, Desloge, MO 63601-2937 | 2015-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902777 | Kimberly Rachelle Troha | Pharmacist | 605 S Jewel Ct, Nixa, MO 65714-7590 | 2020-11-06 |
| 1225639065 | Kimberly Frederich | Pharmacist | 6149 N Mattox Rd, Kansas City, MO 64151-2579 | 2020-11-06 |
| 1386245108 | Stephanie Mummert | Pharmacist | 404 Nw Highcliffe Dr, Lees Summit, MO 64081-2061 | 2020-11-06 |
| 1023619038 | William Molenaar | Pharmacist | 18401 State Hwy 13, Branson West, MO 65737 | 2020-11-05 |
| 1235730243 | Jeffery William Ellis | Pharmacist | 1571 Wentzville Parkway, Wentzville, MO 63385 | 2020-11-05 |
| 1457952624 | Brian Gregory Young | Pharmacist | 185 St.robert Blvd, St. Robert, MO 65584-6558 | 2020-11-04 |
| 1013518224 | Brian James Voss | Pharmacist | 512 Deer Pointe Ct, Fenton, MO 63026-3061 | 2020-11-04 |
| 1730780917 | Amy Benson | Pharmacist | 5100 N Towne Centre Dr, Ozark, MO 65721-7479 | 2020-11-04 |
| 1952902355 | Aaron Kate Menley | Pharmacist | 2025 West Business Highway 60, Dexter, MO 63841-6384 | 2020-11-03 |
| 1447851043 | Elizabeth Ahrens | Pharmacist | 625 Sw Us Highway 40, Blue Springs, MO 64014-3232 | 2020-11-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.