Provider Demographics
NPI:1376944181
Name:ANDERSON, CASSANDRA SKYE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:SKYE
Last Name:ANDERSON
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 1:21241 N 23RD AVE
Mailing Address - Street 2:STE 21
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2537
Mailing Address - Country:US
Mailing Address - Phone:520-387-5500
Mailing Address - Fax:
Practice Address - Street 1:21241 N 23RD AVE
Practice Address - Street 2:STE 21
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2537
Practice Address - Country:US
Practice Address - Phone:520-387-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist