Active NPI
Larry D Sanders, RPH
- Pharmacotherapy Pharmacist
- Lake Havasu City, AZ
National Provider Identifier
1629416938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- S017258
- Practice address
- 3076 Tom Tom Dr
Lake Havasu City, AZ 86406-8630 - Phone
- (618) 322-3483
- NPI assigned
- Jun 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | S017258 | AZ | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | 051.028931 | IL | |
| Pharmacotherapy Pharmacist | 1835P1200X | 17666 | NV |
Addresses
Primary practice location
3076 Tom Tom Dr
Lake Havasu City, AZ 86406-8630
Mailing address
3076 Tom Tom Dr
Lake Havasu City, AZ 86406-8630
Phone (618) 322-3483
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S017258 | AZ | MD | Pharmacotherapy Pharmacist |
| 051.028931 | IL | MD | Pharmacotherapy Pharmacist |
| 17666 | NV | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370649600000",
"number": "1629416938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3076 TOM TOM DR",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864068630",
"telephone_number": "618-322-3483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3076 TOM TOM DR",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864068630",
"telephone_number": "618-322-3483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "LARRY",
"middle_name": "D",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-08",
"last_updated": "2013-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "AZ",
"license": "S017258",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "IL",
"license": "051.028931",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NV",
"license": "17666",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
- Salt and Light Counseling LLC
- San Luis Walk-in Clinic, Inc. (Lake Havasu Pediatric Family Clinic)
- San Luis Walk-in Clinic, Inc. (Lake Havasu Pediatric & Family Clinic)
- San Luis Walk-in Clinic, Inc. (Lake Havasu Pediatric Family Clinic - Mobile Unit)
- Ashley R Sanchez
- Savana Sanders, SLPA
- Debra Lynn Sandoval
- Olivia Yvette Sandoval, RN
- Jocelyn Santos
- Shawna Marie Sattler, RDH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.