Provider Demographics
NPI:1487309977
Name:SCHEBAUM, JOESPH THOMAS (PHARMD)
Entity type:Individual
Prefix:
First Name:JOESPH
Middle Name:THOMAS
Last Name:SCHEBAUM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 HWY 100 WEST
Mailing Address - Street 2:
Mailing Address - City:HERMANN
Mailing Address - State:MO
Mailing Address - Zip Code:65041-4912
Mailing Address - Country:US
Mailing Address - Phone:573-486-2873
Mailing Address - Fax:573-486-5463
Practice Address - Street 1:1932 HIGHWAY NN
Practice Address - Street 2:
Practice Address - City:HERMANN
Practice Address - State:MO
Practice Address - Zip Code:65041-4912
Practice Address - Country:US
Practice Address - Phone:314-605-3601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019025994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist