Provider Demographics
NPI:1528262557
Name:GASS, LYNDA E (PHARMD)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:E
Last Name:GASS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 PORTWEST CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-2357
Mailing Address - Country:US
Mailing Address - Phone:316-832-2224
Mailing Address - Fax:
Practice Address - Street 1:515 N HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4909
Practice Address - Country:US
Practice Address - Phone:316-962-2305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist