Provider Demographics
NPI:1649562265
Name:SANDRONI, CYNTHIA L (RPH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:SANDRONI
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 1:114 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204-5718
Mailing Address - Country:US
Mailing Address - Phone:601-371-1452
Mailing Address - Fax:601-372-7102
Practice Address - Street 1:114 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-5718
Practice Address - Country:US
Practice Address - Phone:601-371-1452
Practice Address - Fax:601-372-7102
Is Sole Proprietor?:No
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-06271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist