Provider Demographics
NPI:1679631147
Name:NORWOOD, ALYSSA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:L
Last Name:NORWOOD
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 1:125 FENRIR DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-3301
Mailing Address - Country:US
Mailing Address - Phone:803-719-3780
Mailing Address - Fax:
Practice Address - Street 1:40 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-9406
Practice Address - Country:US
Practice Address - Phone:803-438-5537
Practice Address - Fax:803-438-5546
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC008416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist