Provider Demographics
NPI:1497119499
Name:FERGUSON, ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:FERGUSON
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 1:1128 WILLIAMSBURG PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3731
Mailing Address - Country:US
Mailing Address - Phone:785-550-2599
Mailing Address - Fax:
Practice Address - Street 1:1025 N 3RD ST STE 110
Practice Address - Street 2:HEARTLAND HOMECARE
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044
Practice Address - Country:US
Practice Address - Phone:785-331-0807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist