Healthcare Provider Details

I. General information

NPI: 1629087390
Provider Name (Legal Business Name): BETHANY LYNNE BRYANT PHARM.D., BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 BEE ST DEPARTMENT OF PHARMACY
CHARLESTON SC
29401-5703
US

IV. Provider business mailing address

109 BEE ST DEPARTMENT OF PHARMACY
CHARLESTON SC
29401-5703
US

V. Phone/Fax

Practice location:
  • Phone: 843-789-6526
  • Fax: 843-805-5790
Mailing address:
  • Phone: 843-789-6526
  • Fax: 843-805-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number009650
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number009650
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: