Provider Demographics
NPI:1467939454
Name:CUDE, GAY LYNN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:LYNN
Last Name:CUDE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13025 OLDFARM DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4360
Mailing Address - Country:US
Mailing Address - Phone:314-378-1824
Mailing Address - Fax:314-994-4586
Practice Address - Street 1:13025 OLDFARM DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4360
Practice Address - Country:US
Practice Address - Phone:618-451-0521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002027549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist