Provider Demographics
NPI:1851358055
Name:FLINT-SMITH, SANDRA LYDIA (RPH)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LYDIA
Last Name:FLINT-SMITH
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 1:5899 FLINT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63051-1401
Mailing Address - Country:US
Mailing Address - Phone:314-652-4100
Mailing Address - Fax:314-894-5731
Practice Address - Street 1:5899 FLINT RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051-1401
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:314-894-5731
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist