Michael G Humphrey, PHARM D
Individual provider Active NPI Pharmacist · Webb City, MO
NPI 1174908255 · NPPES record last updated Jul 30, 2015
Key facts
- NPI
- 1174908255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 211032453 (MO)
- Practice address
- 8939 County Lane 213
Webb City, MO 64870-7202 - Phone
- (417) 680-2025
- Fax
- (417) 680-2026
- NPI assigned
- Jul 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115457 | KS | MD | Pharmacist |
| 211032453 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 115457 | KS | |
| Pharmacist | 183500000X | 211032453 | MO | Yes |
Addresses
Primary practice location
8939 County Lane 213
Webb City, MO 64870-7202
Mailing address
8939 County Lane 213
Webb City, MO 64870-7202
Phone (417) 680-2025
Other providers in Webb City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.