Provider Demographics
NPI:1306322417
Name:COMBS, CHRISTY (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:HENNEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2511 KEHRS MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7358
Mailing Address - Country:US
Mailing Address - Phone:636-207-3403
Mailing Address - Fax:
Practice Address - Street 1:2511 KEHRS MILL RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7358
Practice Address - Country:US
Practice Address - Phone:636-207-3403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110265651835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist