Mallory Sierra Gardner, PHARM.D
Individual provider Active NPI Pharmacist · Brookfield, MO
NPI 1558037853 · NPPES record last updated Aug 18, 2021
Key facts
- NPI
- 1558037853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2021032276 (MO)
- Practice address
- 712 S Main St
Brookfield, MO 64628-2307 - Phone
- (660) 258-2122
- NPI assigned
- Aug 18, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021032276 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gardner Pharmacy Services Inc | Current |
Accepting new patients | |
| Gardner Pharmacy Services Inc | Past |
Accepting new patients |
Locations
712 S Main St
Brookfield, MO 64628
Phone (660) 258-2122
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2021032276 | MO | Yes |
Addresses
Primary practice location
712 S Main St
Brookfield, MO 64628-2307
Mailing address
712 S Main St
Brookfield, MO 64628-2307
Phone (660) 258-2122
Other providers in Brookfield, MO
- Gary W Fite
- Gardner Pharmacy Services Inc
- Gardner Pharmacy Services Inc
- Gardner Pharmacy Services, Inc.
- David Nicholson Gardner
- General John J Perhsing Memorial Hospital Association
- General John J Pershing Memorial Hospital
- General John J Pershing Memorial Hospital
- General John J Pershing Memorial Hospital Association
- General John J Pershing Memorial Hospital Association
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.