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NPI Code Detail

MEDICARE: NICOLE MARIE SANDER RPH

MEDICARE:   NICOLE MARIE SANDER  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist16597LA
2183500000XPharmacist35602TX

General Provider Information

NPI Number : 1538453543
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MARIE SANDER RPH
Provider Business Mailing Address
First Line : 5115 ALCOTT ST
Second Line :
City : DALLAS
State : TX
Zip : 75206-6611
Country : US
Telephone Number : 214-824-4182
Fax Number :
Provider Business Practice Location Address
First Line : 5115 ALCOTT ST
Second Line :
City : DALLAS
State : TX
Zip : 75206-6611
Country : US
Telephone Number : 214-824-4182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2011
Last Update Date : 06/07/2011

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Directions to “ NICOLE MARIE SANDER RPH” Practice Location

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