Provider Demographics
NPI:1619250594
Name:PIPKIN, CINDY R (RPH)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:R
Last Name:PIPKIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:R
Other - Last Name:PIPKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2067 MALLARD CV
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-6395
Mailing Address - Country:US
Mailing Address - Phone:901-626-1163
Mailing Address - Fax:
Practice Address - Street 1:6958 GOODMAN RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-7034
Practice Address - Country:US
Practice Address - Phone:662-890-5047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist