Provider Demographics
NPI:1265190664
Name:SAUNDERS, CASSANDRA (PHARMD)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 133RD LN NE
Mailing Address - Street 2:
Mailing Address - City:HAM LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55304-7005
Mailing Address - Country:US
Mailing Address - Phone:651-276-7979
Mailing Address - Fax:
Practice Address - Street 1:1420 LAKE ST S STE 100
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2714
Practice Address - Country:US
Practice Address - Phone:651-464-5518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist