Provider Demographics
NPI:1205067477
Name:ALBERS, DENNIS L (RPH, MBA)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:L
Last Name:ALBERS
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1560
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-1560
Mailing Address - Country:US
Mailing Address - Phone:573-964-6200
Mailing Address - Fax:573-964-6452
Practice Address - Street 1:1870 BAGNELL DAM BLVD
Practice Address - Street 2:
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-8658
Practice Address - Country:US
Practice Address - Phone:573-964-6200
Practice Address - Fax:573-964-6452
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003008878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist