Healthcare Provider Details
I. General information
NPI: 1265534788
Provider Name (Legal Business Name): JANELLE LEA MALAND PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/04/2006
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 HOSPITAL DR
COLUMBIA MO
65201-5275
US
IV. Provider business mailing address
3315 APPALACHIAN DR
COLUMBIA MO
65203-0159
US
V. Phone/Fax
- Phone: 573-814-6400
- Fax:
- Phone: 573-397-8709
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 14279 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835X0200X |
| Taxonomy | Oncology Pharmacist |
| License Number | S014279 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: