Provider Demographics
NPI:1659689115
Name:CHANDLER, LORIE V (RPH)
Entity type:Individual
Prefix:
First Name:LORIE
Middle Name:V
Last Name:CHANDLER
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 1:102 NORFLEET DR
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-2220
Mailing Address - Country:US
Mailing Address - Phone:662-562-8021
Mailing Address - Fax:662-562-7754
Practice Address - Street 1:102 NORFLEET DR
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2220
Practice Address - Country:US
Practice Address - Phone:662-562-8021
Practice Address - Fax:662-562-7754
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist