Provider Demographics
NPI:1467099853
Name:HEESE, SABLE K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SABLE
Middle Name:K
Last Name:HEESE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SABLE
Other - Middle Name:K
Other - Last Name:HUEBNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:532 FAIRFIELD VALLEY ROAD
Mailing Address - Street 2:PO BOX 470
Mailing Address - City:SAINT ALBANS
Mailing Address - State:MO
Mailing Address - Zip Code:63073
Mailing Address - Country:US
Mailing Address - Phone:573-263-0682
Mailing Address - Fax:
Practice Address - Street 1:2511 KEHRS MILL RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7358
Practice Address - Country:US
Practice Address - Phone:636-207-3403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051302737183500000X
MO2019040910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051302737OtherPHARMACIST LICENSE
MO2019040910OtherPHARMACIST LICENSE