Provider Demographics
NPI:1639471527
Name:MATTHEWS, SHAWANDA RATCHFORD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHAWANDA
Middle Name:RATCHFORD
Last Name:MATTHEWS
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 1:2723 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-4003
Mailing Address - Country:US
Mailing Address - Phone:803-276-7668
Mailing Address - Fax:803-276-7378
Practice Address - Street 1:2723 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-4003
Practice Address - Country:US
Practice Address - Phone:803-276-7668
Practice Address - Fax:803-276-7378
Is Sole Proprietor?:No
Enumeration Date:2010-11-26
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist