Provider Demographics
NPI:1306018999
Name:SHARPE, HEATHER DENISE (PHARMD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DENISE
Last Name:SHARPE
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 1:2476 FULFORD COURT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466
Mailing Address - Country:US
Mailing Address - Phone:843-545-8800
Mailing Address - Fax:843-545-8803
Practice Address - Street 1:810 ELIZABETH STREET
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440
Practice Address - Country:US
Practice Address - Phone:843-545-8800
Practice Address - Fax:843-545-8803
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101201835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC779713Medicaid