Provider Demographics
NPI:1003014226
Name:KOLKMEYER, CINDY KAY (PHARM D)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:KAY
Last Name:KOLKMEYER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 N MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:MARCELINE
Mailing Address - State:MO
Mailing Address - Zip Code:64658-1009
Mailing Address - Country:US
Mailing Address - Phone:660-376-2700
Mailing Address - Fax:660-376-2701
Practice Address - Street 1:1509 N MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:MARCELINE
Practice Address - State:MO
Practice Address - Zip Code:64658-1009
Practice Address - Country:US
Practice Address - Phone:660-376-2700
Practice Address - Fax:660-376-2701
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO009848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist