Provider Demographics
NPI:1538315932
Name:SWEAT, MARSHALL RANDALL (RPH)
Entity Type:Individual
Prefix:
First Name:MARSHALL
Middle Name:RANDALL
Last Name:SWEAT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 WERTZ DR.
Mailing Address - Street 2:BOX 396
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376
Mailing Address - Country:US
Mailing Address - Phone:910-673-7791
Mailing Address - Fax:910-947-3878
Practice Address - Street 1:1006 MONROE ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-7387
Practice Address - Country:US
Practice Address - Phone:910-947-2690
Practice Address - Fax:910-947-3878
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist