Provider Demographics
NPI:1104945658
Name:EADY, CYNTHIA SCOTT (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SCOTT
Last Name:EADY
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WATEKA WAY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4013
Mailing Address - Country:US
Mailing Address - Phone:972-235-7133
Mailing Address - Fax:972-235-6968
Practice Address - Street 1:819 W ARAPAHO RD STE 57
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5038
Practice Address - Country:US
Practice Address - Phone:972-235-7133
Practice Address - Fax:972-235-6968
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3701-0106-0954-515247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX051-7020001Medicare ID - Type UnspecifiedARAPAHO PHARMACY