Provider Demographics
NPI:1144510264
Name:SWORD WARD, MISTY D (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MISTY
Middle Name:D
Last Name:SWORD WARD
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:PO BOX 980
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:VA
Mailing Address - Zip Code:24283-0980
Mailing Address - Country:US
Mailing Address - Phone:276-762-5011
Mailing Address - Fax:276-762-7030
Practice Address - Street 1:16435 WISE STREET
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:VA
Practice Address - Zip Code:24283
Practice Address - Country:US
Practice Address - Phone:276-762-5011
Practice Address - Fax:276-762-7030
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist