Provider Demographics
NPI:1831197078
Name:DRIVER, RHONDA ALEXANDER (RPH)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:ALEXANDER
Last Name:DRIVER
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 1:314 KENT ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-6107
Mailing Address - Country:US
Mailing Address - Phone:573-635-2305
Mailing Address - Fax:573-522-8514
Practice Address - Street 1:2023 SAINT MARYS BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1101
Practice Address - Country:US
Practice Address - Phone:573-751-6961
Practice Address - Fax:573-522-8514
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043852183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist