Provider Demographics
NPI:1467596064
Name:DIXON, RANARDA MISHEA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RANARDA
Middle Name:MISHEA
Last Name:DIXON
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 1:6 CROWN POINT CT
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2912
Mailing Address - Country:US
Mailing Address - Phone:803-781-0871
Mailing Address - Fax:
Practice Address - Street 1:6 CROWN POINT CT
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2912
Practice Address - Country:US
Practice Address - Phone:803-781-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist