Provider Demographics
NPI:1902287733
Name:WOODARD, MYEESHA SANTRELL (PHARM D)
Entity Type:Individual
Prefix:
First Name:MYEESHA
Middle Name:SANTRELL
Last Name:WOODARD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 SUNSHINE RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-9208
Mailing Address - Country:US
Mailing Address - Phone:803-804-2700
Mailing Address - Fax:
Practice Address - Street 1:615 W EVANS ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3409
Practice Address - Country:US
Practice Address - Phone:843-472-5066
Practice Address - Fax:803-472-5062
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist