Healthcare Provider Details

I. General information

NPI: 1285033357
Provider Name (Legal Business Name): SHWETA WOODSMALL PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5233 CLEVELAND HWY
CLERMONT GA
30527-2205
US

IV. Provider business mailing address

5233 CLEVELAND HWY
CLERMONT GA
30527-2205
US

V. Phone/Fax

Practice location:
  • Phone: 770-983-9556
  • Fax:
Mailing address:
  • Phone: 770-983-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH028054
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: