Spudich, Tiffany

Spudich, Tiffany is an individual health care provider with primary practice located at 212 Millwell Dr Suite A, Maryland Heights MO 63043-2512. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Spudich, Tiffany can be contacted via phone (314) 727-8787.

Contact Information

Primary practice address
212 Millwell Dr Suite A Maryland Heights MO 63043-2512
Phone: (314) 727-8787
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 2004009350 Missouri
Pharmacy Service Providers / Pharmacist 183500000X 51290447 Illinois

Profile Details

NPI number 1154524387
LBN Legal business name Spudich, Tiffany
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2007
Last updated Jan 17th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154524387 NPPES
Missouri MEDICAID 351039805

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