Provider Demographics
NPI:1194075473
Name:VILLAROMAN, CECYL TIONGSON (RPH)
Entity type:Individual
Prefix:MRS
First Name:CECYL
Middle Name:TIONGSON
Last Name:VILLAROMAN
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 1:315 WEST BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662
Mailing Address - Country:US
Mailing Address - Phone:864-288-1847
Mailing Address - Fax:864-234-1422
Practice Address - Street 1:315 WEST BUTLER RD
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662
Practice Address - Country:US
Practice Address - Phone:864-288-1847
Practice Address - Fax:864-234-1422
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist