Provider Demographics
NPI:1417277476
Name:ROLAND, SUSAN RAMSEY (BS,PHARMD,BCMH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:RAMSEY
Last Name:ROLAND
Suffix:
Gender:F
Credentials:BS,PHARMD,BCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 S LAKE DR
Mailing Address - Street 2:P.O. BOX 84367
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-7739
Mailing Address - Country:US
Mailing Address - Phone:803-312-5070
Mailing Address - Fax:
Practice Address - Street 1:1853 OLD ORANGEBURG RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-7505
Practice Address - Country:US
Practice Address - Phone:803-312-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC007411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist