DR. SIDFUN WONG (NPI# 1093168221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093168221 |
| Entity Type | Individual |
| Full Name | DR. SIDFUN WONG |
| Credential | PHARMD |
| Practice Address |
101 Locust St Lyman SC 29365-1503 |
| Mailing Address |
26 Summer Valley Ct Greer SC 29651-5636 |
| Practice Telephone | 8644391040 |
| Mailing Telephone | 8438132303 |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 36623 | SC | Pharmacy Service Providers |
| Street Address |
101 LOCUST ST |
| City | LYMAN |
| State | SC |
| Zip Code | 29365-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437252111 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 101 Locust St, Lyman, SC 29365-1503 | 2006-09-07 |
| 1033721352 | Anna Skinner Wyatt | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2020-08-18 |
| 1215413026 | Shiva Shila Tavassoli | Pharmacist | 101 Locust St, Lyman, SC 29365 | 2018-07-15 |
| 1295289007 | Jessica Miranda Vanoverstraeten | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2016-08-09 |
| 1013385020 | Karen Kelly | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2015-09-08 |
| 1689041535 | Ann Nicholson | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2015-08-26 |
| 1598013476 | Marsha Lynn Piccuta | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2012-08-27 |
| 1255689154 | Clarence Edsel Peacock | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2012-08-27 |
| 1396093217 | Kelly Woodward | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2012-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902203813 | Stephanie Walker | Nurse Practitioner | 1295 Old Spartanburg Hwy, Careteam Health, Lyman, SC 29365 | 2014-11-21 |
| 1013356161 | Tyger River Pediatric Dentistry | Dentist | 312 Spartanburg Hwy., Lyman, SC 29365 | 2013-06-21 |
| 1649436791 | Ashlan Village Retirement Community | Assisted Living Facility | 415 Brenda Way, Lyman, SC 29365 | 2008-07-29 |
| 1538379086 | Lyman Dental Associates PC | Dentist | 301 Old Spartanburg Rd., Lyman, SC 29365 | 2007-05-23 |
| 1437297462 | Tina Louise Gaudiano | Counselor | 84 Groce Rd, Lyman, SC 29365 | 2007-02-02 |
| 1255477014 | Cathy Ford Sparks | Counselor | Middle Tyger Community Center, 84 Grace Rd, Lyman, SC 29365 | 2007-01-29 |
| 1194828657 | Kirk E Houston Dmd Pa | Dentist | 12313 Greenville Highway, Lyman, SC 29365 | 2006-09-07 |
| 1245347210 | Grady Stoddard Brooks Jr. | Dentist | 301 Old Spartanburg Road, Lyman, SC 29365 | 2006-08-24 |
| 1750494894 | Brian Kingston Armstrong | Dentist | 350 S Spartanburg Hwy, Lyman, SC 29365 | 2006-08-15 |
| 1164456075 | John Blair Pierce | Physical Therapy Assistant | 104 Gwendolyn Aevnue, Lyman, SC 29365 | 2006-07-10 |
| Find all providers in zip 29365 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578834636 | Carolyn D Pittman | Pharmacist | 14 Birch Acres, Lyman, ME 04002-6080 | 2012-01-21 |
| 1467733089 | Michal Hester Goodwin | Pharmacist | 12189 Greenville Hwy, Lyman, SC 29365-1511 | 2011-09-09 |
| 1033123989 | The Drug Store Inc. | Pharmacist | 106 S. Main St., Lyman, WY 82937 | 2006-07-28 |
| 1033721352 | Anna Skinner Wyatt | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2020-08-18 |
| 1215413026 | Shiva Shila Tavassoli | Pharmacist | 101 Locust St, Lyman, SC 29365 | 2018-07-15 |
| 1295289007 | Jessica Miranda Vanoverstraeten | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2016-08-09 |
| 1013385020 | Karen Kelly | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2015-09-08 |
| 1689041535 | Ann Nicholson | Pharmacist | 101 Locust St, Lyman, SC 29365-1503 | 2015-08-26 |
| 1801280599 | Jeremy Kevin Mullinnix | Pharmacist | 200 Spartanburg Hwy, Lyman, SC 29365-1808 | 2015-03-20 |
| 1891121448 | Gary Allen Lee | Pharmacist | 12189 Greenville Hwy, Lyman, SC 29365-1511 | 2013-09-15 |
| Find all providers in LYMAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.