Provider Demographics
NPI:1619041613
Name:BELFORD, SYLVIA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:MARIE
Last Name:BELFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PINE CT
Mailing Address - Street 2:
Mailing Address - City:CANNON FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55009-7171
Mailing Address - Country:US
Mailing Address - Phone:507-298-7295
Mailing Address - Fax:
Practice Address - Street 1:108 PINE CT
Practice Address - Street 2:
Practice Address - City:CANNON FALLS
Practice Address - State:MN
Practice Address - Zip Code:55009-7171
Practice Address - Country:US
Practice Address - Phone:507-298-7295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13642-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI13642-040OtherPHARMACIST
MNRPH120234OtherPHARMACIST