Provider Demographics
NPI:1528547858
Name:SANDLIN, JUSTIN ANDREW (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ANDREW
Last Name:SANDLIN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 BEGLEY RD S
Mailing Address - Street 2:
Mailing Address - City:MC KEE
Mailing Address - State:KY
Mailing Address - Zip Code:40447-7147
Mailing Address - Country:US
Mailing Address - Phone:423-244-3586
Mailing Address - Fax:
Practice Address - Street 1:2727 S HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-7556
Practice Address - Country:US
Practice Address - Phone:606-598-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist