Active NPI
Sidfun Wong, PHARMD
- Pharmacist
- Lyman, SC
National Provider Identifier
1093168221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36623
- Practice address
- 101 Locust St
Lyman, SC 29365-1503 - Phone
- (864) 439-1040
- NPI assigned
- Jul 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36623 | SC | Primary |
Addresses
Primary practice location
101 Locust St
Lyman, SC 29365-1503
Mailing address
26 Summer Valley CT
Greer, SC 29651-5636
Phone (843) 813-2303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36623 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1093168221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 SUMMER VALLEY CT",
"city": "GREER",
"state": "SC",
"postal_code": "296515636",
"telephone_number": "843-813-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 LOCUST ST",
"city": "LYMAN",
"state": "SC",
"postal_code": "293651503",
"telephone_number": "864-439-1040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "SIDFUN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyman, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.