Provider Demographics
NPI:1154801959
Name:SHEPHERD, ANDREW CHRISTOPHER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHRISTOPHER
Last Name:SHEPHERD
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 1:560 W BRYANT APT B310
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-8320
Mailing Address - Country:US
Mailing Address - Phone:417-920-6198
Mailing Address - Fax:
Practice Address - Street 1:1454 E REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-6507
Practice Address - Country:US
Practice Address - Phone:417-886-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180288611835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist