Provider Demographics
NPI:1104317205
Name:BELLINDER, SONYA R (RPH)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:R
Last Name:BELLINDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-5206
Mailing Address - Country:US
Mailing Address - Phone:785-842-0177
Mailing Address - Fax:785-842-0178
Practice Address - Street 1:3300 IOWA ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-5206
Practice Address - Country:US
Practice Address - Phone:785-842-0177
Practice Address - Fax:785-842-0178
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-11199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-11199OtherPHARMACY LICENSE