1891121604 NPI number — MRS. ASHLEY MARIE EVERHART PHARM.D.

Table of content: MRS. ASHLEY MARIE EVERHART PHARM.D. (NPI 1891121604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891121604 NPI number — MRS. ASHLEY MARIE EVERHART PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EVERHART
Provider First Name:
ASHLEY
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891121604
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36 DRIFTWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELGIN
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29045-8538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-420-3848
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2011 HOFFMEYER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29501-4013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-669-2492
Provider Business Practice Location Address Fax Number:
843-673-9467
Provider Enumeration Date:
09/25/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  14194 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)