Provider Demographics
NPI:1871659169
Name:ANDERSON, SANDRA F (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:F
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:246 SHELTON WAY
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-7949
Mailing Address - Country:US
Mailing Address - Phone:859-498-5393
Mailing Address - Fax:606-780-4554
Practice Address - Street 1:234 MEDICAL CIRCLE
Practice Address - Street 2:MOREHEAD CLINIC PHARMACY
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351
Practice Address - Country:US
Practice Address - Phone:606-784-6696
Practice Address - Fax:606-780-4554
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY12554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist