Provider Demographics
NPI:1851677710
Name:HAMMOND, SHENETTA R (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHENETTA
Middle Name:R
Last Name:HAMMOND
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 1:3895 WEST BROWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1019
Mailing Address - Country:US
Mailing Address - Phone:954-316-6641
Mailing Address - Fax:
Practice Address - Street 1:3895 WEST BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33312-1019
Practice Address - Country:US
Practice Address - Phone:954-316-6641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist