Stacie Lynn Penkova, PHARMD is a
Pharmacist - Pharmacist Clinician (phc)/ Clinical Pharmacy Specialist based in Columbus Afb, Mississippi. Stacie Lynn Penkova is licensed to practice in Mississippi (license number E-008947) and her current practice location is
14th Medical Group, 201 Independence Drive, Columbus Afb, Mississippi. She can be reached at her office (for appointments etc.) via phone at
(662) 434-2273.
NPI number for Stacie Lynn Penkova is 1699372938 and her current mailing address is 14th Medical Group, 201 Independence Drive, Columbus Afb, Mississippi. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1699372938.
Healthcare Provider's Profile
Full Name | Stacie Lynn Penkova |
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Gender | Female |
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Speciality | Pharmacist - Pharmacist Clinician (phc)/ Clinical Pharmacy Specialist |
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Location | 14th Medical Group, Columbus Afb, Mississippi |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1699372938
- Provider Enumeration Date: 10/08/2020
- Last Update Date: 10/08/2020
Medical Identifiers
Medical identifiers for Stacie Lynn Penkova such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699372938 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1835P0018X | Pharmacist - Pharmacist Clinician (phc)/ Clinical Pharmacy Specialist | E-008947 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacie Lynn Penkova is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Stacie Lynn Penkova, PHARMD 14th Medical Group, 201 Independence Drive, Columbus Afb, MS 39710 Ph: (662) 434-2273 | Stacie Lynn Penkova, PHARMD 14th Medical Group, 201 Independence Drive, Columbus Afb, MS 39710 Ph: (662) 434-2273 |
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