Provider Demographics
NPI:1477801231
Name:CHEATHAM, SARA PATRICIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:PATRICIA
Last Name:CHEATHAM
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 1:2908 EMANUEL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-3010
Mailing Address - Country:US
Mailing Address - Phone:803-996-3625
Mailing Address - Fax:
Practice Address - Street 1:2908 EMANUEL CHURCH RD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170-3010
Practice Address - Country:US
Practice Address - Phone:803-996-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist