Provider Demographics
NPI:1649706599
Name:COLE, CYNTHIA K (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:K
Last Name:COLE
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 1:18565 BUSINESS 13
Mailing Address - Street 2:
Mailing Address - City:BRANSON WEST
Mailing Address - State:MO
Mailing Address - Zip Code:65737-9659
Mailing Address - Country:US
Mailing Address - Phone:417-272-8064
Mailing Address - Fax:417-272-0073
Practice Address - Street 1:18565 BUSINESS 13
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-9659
Practice Address - Country:US
Practice Address - Phone:417-272-8064
Practice Address - Fax:417-272-0073
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005004463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist