Provider Demographics
NPI:1114521259
Name:MAWYER, SABRINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:
Last Name:MAWYER
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 1:503 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-4133
Mailing Address - Country:US
Mailing Address - Phone:540-967-0063
Mailing Address - Fax:
Practice Address - Street 1:503 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-4133
Practice Address - Country:US
Practice Address - Phone:540-967-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist