Heather Mandeville, PHARMD, BCPS

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

2006021558 Issued in MO

Practice address

6420 Clayton Rd
Saint Louis, MO 63117-1811

Phone

(314) 768-8365

NPI assigned

Apr 3, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238716800000",
    "number": "1619119773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 FRONTAGE RD",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622345835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEVILLE",
        "first_name": "HEATHER",
        "credential": "PHARMD, BCPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2009-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MO",
            "license": "2006021558",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051.291411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandala Medical Services, LLC
• Iris M Mandell, MD
• Ivonne I Mandell, NNP
• Mary J Mandello, PHD
• Emily Ferrara Mandernach, ACNP
• Akash Mandhan, MD
• Anantha N Manepalli, M.D.
• Scotti Manes, DNP-PC, CPNP
• Ralph Maney, LPN
• Arushi Manga, MD

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.