Provider Demographics
NPI:1548535651
Name:WINT, SUSAN RENE (PHARMD)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:RENE
Last Name:WINT
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 1:1851 HIGHWAY 14 E
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-9698
Mailing Address - Country:US
Mailing Address - Phone:864-457-4598
Mailing Address - Fax:864-457-4742
Practice Address - Street 1:1851 HIGHWAY 14 E
Practice Address - Street 2:
Practice Address - City:LANDRUM
Practice Address - State:SC
Practice Address - Zip Code:29356-1969
Practice Address - Country:US
Practice Address - Phone:864-457-4598
Practice Address - Fax:864-457-4742
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist