Theodore Joshua Olbricht

Primary specialty

PharmacistTaxonomy code 183500000X

License

2003004928 Issued in MO

Practice address

#1 Viburnum Center Suite B
Viburnum, MO 65566

Phone

(573) 244-3785

Fax

(573) 244-3700

NPI assigned

Apr 1, 2024

Last updated

Apr 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• C&P Viburnum Ventures LLC

  dba Iron County Drug Store

  • Community/Retail Pharmacy
  • Viburnum, MO
  • NPI 1184092793
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1730930165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 COUNTRYSIDE DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014722",
            "telephone_number": "765-491-3220",
            "fax_number": "573-244-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#1 VIBURNUM CENTER SUITE B",
            "city": "VIBURNUM",
            "state": "MO",
            "postal_code": "65566",
            "telephone_number": "573-244-3785",
            "fax_number": "573-244-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLBRICHT",
        "first_name": "THEODORE",
        "middle_name": "JOSHUA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2003004928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Disabled Citizens Alliance for Independence Foundation, Inc (DCAI Foundation)
• Iron County C-4 School District
• Iron County EMS
• Lester E Cox Medical Centers (Coxhealth School Based Telemedicine)
• Mma Healthcare of Viburnum, Inc. (Stonecrest Healthcare)
• Deana Payne, LCSW
• Linda Sue Pyatt
• Vanessa R Roper, LPN
• Stonecrest SNF Opco LLC (Stonecrest Healthcare)

• Pharmacist in Viburnum, MO
• Providers in Viburnum, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.