Provider Demographics
NPI:1861691313
Name:BRICKER, PAUL H (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:H
Last Name:BRICKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8786 STATE HIGHWAY BB
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-6832
Mailing Address - Country:US
Mailing Address - Phone:417-235-3799
Mailing Address - Fax:636-246-0050
Practice Address - Street 1:8786 STATE HIGHWAY BB
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-6832
Practice Address - Country:US
Practice Address - Phone:417-235-3799
Practice Address - Fax:636-246-0050
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPH0435911835P0018X, 1835P1200X, 1835P2201X, 1835X0200X, 183500000X
NC163181835P1200X, 1835P2201X, 1835X0200X, 1835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835X0200XPharmacy Service ProvidersPharmacistOncology