Provider Demographics
NPI:1366411134
Name:WESTMORELAND, SERENA HAMMOND (CPHT)
Entity type:Individual
Prefix:MRS
First Name:SERENA
Middle Name:HAMMOND
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14052 S RADIO STATION RD
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-1013
Mailing Address - Country:US
Mailing Address - Phone:864-882-9362
Mailing Address - Fax:864-888-0019
Practice Address - Street 1:15891 WELLS HWY
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1078
Practice Address - Country:US
Practice Address - Phone:864-888-0405
Practice Address - Fax:864-888-0019
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22195183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician