Provider Demographics
NPI:1043053432
Name:STITH, CASSANDRA (PHARMD)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:STITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:HARDESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:800 E 20TH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3884
Mailing Address - Country:US
Mailing Address - Phone:307-995-1560
Mailing Address - Fax:307-996-1565
Practice Address - Street 1:800 E 20TH ST STE 350
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3884
Practice Address - Country:US
Practice Address - Phone:307-995-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0021265183500000X
WY38411835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist