Provider Demographics
NPI:1306253927
Name:COMBS, CANDACE (PHARM D)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 N ROCK RD
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-3718
Mailing Address - Country:US
Mailing Address - Phone:316-554-2121
Mailing Address - Fax:316-554-2125
Practice Address - Street 1:1624 N ROCK RD
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-3718
Practice Address - Country:US
Practice Address - Phone:316-554-2121
Practice Address - Fax:316-554-2125
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist