Healthcare Provider Details

I. General information

NPI: 1083448336
Provider Name (Legal Business Name): ASHLEY MICHELLE HORRAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 RUTLEDGE AVE FL 1
CHARLESTON SC
29425-8903
US

IV. Provider business mailing address

150 ASHLEY AVE # MSC584
CHARLESTON SC
29425-8907
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-0199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number44078
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: