Provider Demographics
NPI:1710681119
Name:MANESS, CASSIE LYN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:LYN
Last Name:MANESS
Suffix:
Gender:F
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 1:50 BIG TREE TRL
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MO
Mailing Address - Zip Code:65622-4193
Mailing Address - Country:US
Mailing Address - Phone:417-894-7770
Mailing Address - Fax:855-662-4032
Practice Address - Street 1:1100 S SPRINGFIELD AVE STE A
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-2512
Practice Address - Country:US
Practice Address - Phone:417-328-4700
Practice Address - Fax:855-662-4032
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190368941835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist