Provider Demographics
NPI:1689683096
Name:WISCHOVER, LINDA JEAN (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JEAN
Last Name:WISCHOVER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 E WILSON TURNER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-9378
Mailing Address - Country:US
Mailing Address - Phone:573-886-7700
Mailing Address - Fax:573-814-6533
Practice Address - Street 1:800 HOSPITAL DR
Practice Address - Street 2:HARRY S. TRUMAN VA HOSPITAL
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5275
Practice Address - Country:US
Practice Address - Phone:573-814-6534
Practice Address - Fax:573-814-6533
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO045145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist