Basic Information
| Provider Information | |||||||||
| NPI: | 1649806654 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOODS | ||||||||
| FirstName: | HALEY | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 922 VISTA TOWERS DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292012370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068368294 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1355 KNOX ABBOTT DR | ||||||||
| Address2: | |||||||||
| City: | CAYCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290333327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032230754 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2020 | ||||||||
| LastUpdateDate: | 03/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 42320 | SC | N | Pharmacy Service Providers | Pharmacist | 183500000X | RPH029806 | GA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.