Provider Demographics
NPI:1285042614
Name:HAROLD, ALLISON RENEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RENEE
Last Name:HAROLD
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 1:202 SIEMERS DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-8419
Mailing Address - Country:US
Mailing Address - Phone:573-334-6578
Mailing Address - Fax:
Practice Address - Street 1:202 SIEMERS DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-8419
Practice Address - Country:US
Practice Address - Phone:573-334-6578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014026375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist