Healthcare Provider Details

I. General information

NPI: 1841280096
Provider Name (Legal Business Name): SHARWANDA LYSHAUN GEORGE PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT GEORGE G MEADE MD
20755-7081
US

IV. Provider business mailing address

2480 LLEWELLYN AVE
FORT GEORGE G MEADE MD
20755-7081
US

V. Phone/Fax

Practice location:
  • Phone: 703-696-7924
  • Fax:
Mailing address:
  • Phone: 703-696-7924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202204164
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202204164
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: