Tracy Alcorn, CPHT

Individual provider Active NPI Pharmacy Technician · Republic, MO

NPI 1629705272 · NPPES record last updated Nov 14, 2023

Key facts

NPI
1629705272
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
2013017536 (MO)
Practice address
1173 E Hines St
Republic, MO 65738-1277
Phone
(417) 735-0055
NPI assigned
Aug 3, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2013017536MOMDPharmacy Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 2013017536 MO Yes

Addresses

Primary practice location

1173 E Hines St
Republic, MO 65738-1277

Mailing address

1173 E Hines St
Republic, MO 65738-1277
Phone (417) 735-0055

Other providers in Republic, MO

All providers in Republic, MO · Pharmacy Technician in Missouri

Sources for this page

Verify at the official NPI Registry.