Provider Demographics
NPI:1851495022
Name:VORIS, CYNTHIA TATUM (PHARM D)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:TATUM
Last Name:VORIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 GOLDEN SPUR LN
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-7600
Mailing Address - Country:US
Mailing Address - Phone:803-333-9944
Mailing Address - Fax:
Practice Address - Street 1:WJBD VAMC (PHARMACY)
Practice Address - Street 2:6439 GARNERS FERRY ROAD
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1639
Practice Address - Country:US
Practice Address - Phone:803-695-6806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist