Provider Demographics
NPI:1154144467
Name:STEUBER, CARLY OWENS (PHARMD)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:OWENS
Last Name:STEUBER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 BUFFINGTON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0317
Mailing Address - Country:US
Mailing Address - Phone:417-461-4160
Mailing Address - Fax:
Practice Address - Street 1:308 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1243
Practice Address - Country:US
Practice Address - Phone:660-248-2217
Practice Address - Fax:660-248-3450
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230033931835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care