Provider Demographics
NPI:1043947021
Name:SANDRAPATY, TIFFINY AMANDA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TIFFINY
Middle Name:AMANDA
Last Name:SANDRAPATY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 VISTA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29172-2306
Mailing Address - Country:US
Mailing Address - Phone:803-881-4188
Mailing Address - Fax:
Practice Address - Street 1:343 PINEWOOD RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-5442
Practice Address - Country:US
Practice Address - Phone:803-305-6238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist