Provider Demographics
NPI:1720408198
Name:OSTERKAMP, ANDREW (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:OSTERKAMP
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 1:106 BROADWAY ST
Mailing Address - Street 2:STE A
Mailing Address - City:ELSBERRY
Mailing Address - State:MO
Mailing Address - Zip Code:63343-1345
Mailing Address - Country:US
Mailing Address - Phone:573-898-2550
Mailing Address - Fax:573-898-5730
Practice Address - Street 1:302 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ELSBERRY
Practice Address - State:MO
Practice Address - Zip Code:63343-1233
Practice Address - Country:US
Practice Address - Phone:573-898-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013026250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist