Provider Demographics
NPI:1588912729
Name:TWARDY, JANIENE
Entity type:Individual
Prefix:MRS
First Name:JANIENE
Middle Name:
Last Name:TWARDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SAYEBROOK PKWY
Mailing Address - Street 2:T-2742
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-6834
Mailing Address - Country:US
Mailing Address - Phone:843-294-6572
Mailing Address - Fax:
Practice Address - Street 1:140 SAYEBROOK PKWY
Practice Address - Street 2:T-2742
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-6834
Practice Address - Country:US
Practice Address - Phone:843-294-6572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist