Provider Demographics
NPI:1124437009
Name:THROM, LYNDON GENE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LYNDON
Middle Name:GENE
Last Name:THROM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 S. 169 HWY
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089
Mailing Address - Country:US
Mailing Address - Phone:816-532-0977
Mailing Address - Fax:816-532-8444
Practice Address - Street 1:1103 S. 169 HWY
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089
Practice Address - Country:US
Practice Address - Phone:816-532-0977
Practice Address - Fax:816-532-8444
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004020851183500000X
KS1-13634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist