Provider Demographics
NPI:1255663597
Name:GROOMS, WENDY OAKS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:OAKS
Last Name:GROOMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3119
Mailing Address - Country:US
Mailing Address - Phone:803-798-7699
Mailing Address - Fax:803-798-7699
Practice Address - Street 1:6021 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3119
Practice Address - Country:US
Practice Address - Phone:803-798-7699
Practice Address - Fax:803-798-7699
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist