Provider Demographics
NPI:1558795864
Name:TOOLEY, SANDRA KAY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAY
Last Name:TOOLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:KAY
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613
Mailing Address - Country:US
Mailing Address - Phone:417-328-6424
Mailing Address - Fax:417-328-7018
Practice Address - Street 1:1500 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613
Practice Address - Country:US
Practice Address - Phone:417-328-6424
Practice Address - Fax:417-328-7018
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051296687183500000X
MO2013029810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist