Provider Demographics
NPI:1558469692
Name:POSTON, MANDY SHEALEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MANDY
Middle Name:SHEALEY
Last Name:POSTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 STUART STREET
Mailing Address - Street 2:MONCRIEF ARMY COMMUNITY HOSPITAL ATTN: MCXL-PQ
Mailing Address - City:FORT JACKSON
Mailing Address - State:SC
Mailing Address - Zip Code:29207-5720
Mailing Address - Country:US
Mailing Address - Phone:803-751-2024
Mailing Address - Fax:803-751-2689
Practice Address - Street 1:4500 STUART STREET
Practice Address - Street 2:MONCRIEF ARMY COMMUNITY HOSPITAL/CREDENTIALS
Practice Address - City:FORT JACKSON
Practice Address - State:SC
Practice Address - Zip Code:29207-5720
Practice Address - Country:US
Practice Address - Phone:803-751-2024
Practice Address - Fax:803-751-2689
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC0106201835P1200X
SC106201835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD 000Medicare UPIN