Provider Demographics
NPI:1497069686
Name:PENAFLOR, MARIA VICTORIA S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA VICTORIA
Middle Name:S
Last Name:PENAFLOR
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 1:1510 W O EZELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-2616
Mailing Address - Country:US
Mailing Address - Phone:864-574-0038
Mailing Address - Fax:
Practice Address - Street 1:1510 W O EZELL BLVD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-2616
Practice Address - Country:US
Practice Address - Phone:864-574-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist