Provider Demographics
NPI:1285984831
Name:SANDS, COURTNEY (PHARMD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SANDS
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 1:914 WEST GEORGIA ROAD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680
Mailing Address - Country:US
Mailing Address - Phone:864-228-1723
Mailing Address - Fax:864-967-4942
Practice Address - Street 1:914 WEST GEORGIA ROAD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680
Practice Address - Country:US
Practice Address - Phone:864-228-1723
Practice Address - Fax:864-967-4942
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist