Andrea Elise O'Dell, PHARMD
Individual provider Active NPI Pharmacist · Auburn, IL
NPI 1881027803 · NPPES record last updated Aug 13, 2013
Key facts
- NPI
- 1881027803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.296753 (IL)
- Practice address
- 414 N. 5TH Street
Auburn, IL 62615 - Phone
- (217) 821-7012
- NPI assigned
- Aug 13, 2013
- Sex
- Female
- 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 |
|---|---|---|---|
| 051.296753 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.296753 | IL | Yes |
Addresses
Primary practice location
414 N. 5TH Street
Auburn, IL 62615
Mailing address
414 N. 5TH Street
Auburn, IL 62615
Phone (217) 821-7012
Other providers in Auburn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2013. 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.