Provider Demographics
NPI:1962414664
Name:MITCHELL, SANDRA KAY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAY
Last Name:MITCHELL
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 1:601 STATE ROUTE 28 E
Mailing Address - Street 2:P. O. BOX 528
Mailing Address - City:OWENSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65066-1450
Mailing Address - Country:US
Mailing Address - Phone:573-437-3440
Mailing Address - Fax:573-437-4963
Practice Address - Street 1:601 STATE ROUTE 28 E
Practice Address - Street 2:
Practice Address - City:OWENSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65066-1450
Practice Address - Country:US
Practice Address - Phone:573-437-3440
Practice Address - Fax:573-437-4963
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO042925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist