Healthcare Provider Details

I. General information

NPI: 1780024497
Provider Name (Legal Business Name): SAUNDRA BYERLEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BROADWAY ST
ELSBERRY MO
63343-1345
US

IV. Provider business mailing address

1732 DISCOVERY DR
WENTZVILLE MO
63385-4946
US

V. Phone/Fax

Practice location:
  • Phone: 573-898-2550
  • Fax:
Mailing address:
  • Phone: 636-327-7448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number029761
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: