Provider Demographics
NPI:1609320852
Name:BYRD, SANDRA BAREFOOT (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:BAREFOOT
Last Name:BYRD
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 1:936 PINEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4620
Mailing Address - Country:US
Mailing Address - Phone:843-332-4203
Mailing Address - Fax:
Practice Address - Street 1:936 PINEY CREEK RD
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4620
Practice Address - Country:US
Practice Address - Phone:843-332-4203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist