Healthcare Provider Details

I. General information

NPI: 1851358055
Provider Name (Legal Business Name): SANDRA LYDIA FLINT-SMITH RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5899 FLINT RIDGE RD
HOUSE SPRINGS MO
63051-1401
US

IV. Provider business mailing address

5899 FLINT RIDGE RD
HOUSE SPRINGS MO
63051-1401
US

V. Phone/Fax

Practice location:
  • Phone: 314-652-4100
  • Fax: 314-894-5731
Mailing address:
  • Phone: 314-652-4100
  • Fax: 314-894-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: