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General NPI Number Information
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NPI Number | 1366725533
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Entity Type | Individual
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Provider Name | ANDREW CHARLES LEWIS PHARM D
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Gender | Male
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 3126 E VALLEY WATER MILL RD APT 1504
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City | SPRINGFIELD
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State | MO
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Zip | 65803-4908
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Country | US
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Telephone | 580-695-4394
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Fax |
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Provider Business Mailing Address
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Address Line | 3126 E VALLEY WATER MILL RD APT 1504
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City | SPRINGFIELD
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State | MO
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Zip | 65803-4908
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Country | US
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Telephone | 580-695-4394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2009028124
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License Number State | MO
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