Provider Demographics
NPI:1689963142
Name:HUDGINS, CYNTHIA (RPH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HUDGINS
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 1:515 CRESWELL AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5812
Mailing Address - Country:US
Mailing Address - Phone:864-225-3996
Mailing Address - Fax:864-225-3996
Practice Address - Street 1:11410 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7502
Practice Address - Country:US
Practice Address - Phone:864-269-4338
Practice Address - Fax:864-269-4310
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist