Provider Demographics
NPI:1467561456
Name:CARDELL, SANDRA FLYNT (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:FLYNT
Last Name:CARDELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 444
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439
Mailing Address - Country:US
Mailing Address - Phone:912-685-4706
Mailing Address - Fax:
Practice Address - Street 1:298 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:COBBTOWN
Practice Address - State:GA
Practice Address - Zip Code:30420-6012
Practice Address - Country:US
Practice Address - Phone:912-684-2765
Practice Address - Fax:912-684-2029
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist