Provider Demographics
NPI:1396161477
Name:WILLIAMS, CYNTHIA D (RPH)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:D
Last Name:WILLIAMS
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 1:1852 HOUNDSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-8552
Mailing Address - Country:US
Mailing Address - Phone:843-319-8290
Mailing Address - Fax:
Practice Address - Street 1:805 ENTERPRISE RD
Practice Address - Street 2:WAL-MART PHARMACY
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-7821
Practice Address - Country:US
Practice Address - Phone:843-841-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11350183500000X
NC12641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist