Basic Information
| Provider Information | |||||||||
| NPI: | 1558469692 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POSTON | ||||||||
| FirstName: | MANDY | ||||||||
| MiddleName: | SHEALEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4500 STUART STREET | ||||||||
| Address2: | MONCRIEF ARMY COMMUNITY HOSPITAL ATTN: MCXL-PQ | ||||||||
| City: | FORT JACKSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292075720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037512024 | ||||||||
| FaxNumber: | 8037512689 | ||||||||
| Practice Location | |||||||||
| Address1: | 4500 STUART STREET | ||||||||
| Address2: | MONCRIEF ARMY COMMUNITY HOSPITAL/CREDENTIALS | ||||||||
| City: | FORT JACKSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292075720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037512024 | ||||||||
| FaxNumber: | 8037512689 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 06/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 010620 | SC | N | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 1835P0018X | 10620 | SC | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.