Provider Demographics
NPI:1528524212
Name:SANDERS, TAYLOR MATTHEW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:MATTHEW
Last Name:SANDERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 GILSTRAP DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3124
Mailing Address - Country:US
Mailing Address - Phone:843-368-7041
Mailing Address - Fax:
Practice Address - Street 1:103 GILSTRAP DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3124
Practice Address - Country:US
Practice Address - Phone:843-368-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC38088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist