Provider Demographics
NPI:1144210923
Name:WOODRUM, SHARON TREVELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:TREVELLE
Last Name:WOODRUM
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 1:1208 S MULBERRY DR
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-6918
Mailing Address - Country:US
Mailing Address - Phone:843-697-4015
Mailing Address - Fax:843-794-6823
Practice Address - Street 1:110 NNPTC CIR # 1451
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-6314
Practice Address - Country:US
Practice Address - Phone:843-794-6302
Practice Address - Fax:843-794-6036
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist