Provider Demographics
NPI:1750112116
Name:THIRION, ANDREW JORDAN (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JORDAN
Last Name:THIRION
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:JORDAN
Other - Last Name:THIRION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2353 S DOLLISON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-3009
Mailing Address - Country:US
Mailing Address - Phone:816-349-2628
Mailing Address - Fax:
Practice Address - Street 1:1320 S GLENSTONE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-0302
Practice Address - Country:US
Practice Address - Phone:417-520-1525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024031573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist