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NPI Code Detail

MEDICARE: MRS. LISA M SANDERS RPH

MEDICARE: MRS. LISA M SANDERS 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
1183500000XPharmacist16629IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972880342
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA M SANDERS RPH
Provider Business Mailing Address
First Line : 5901 DOUGLAS AVE
Second Line :
City : DES MOINES
State : IA
Zip : 50322-3303
Country : US
Telephone Number : 515-331-0599
Fax Number : 515-331-0599
Provider Business Practice Location Address
First Line : 5901 DOUGLAS AVE
Second Line :
City : DES MOINES
State : IA
Zip : 50322-3303
Country : US
Telephone Number : 515-331-0599
Fax Number : 515-331-0599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2011
Last Update Date : 11/13/2011

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Directions to “ MRS. LISA M SANDERS RPH” Practice Location

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