Healthcare Provider Details

I. General information

NPI: 1942695614
Provider Name (Legal Business Name): COREY CLARDY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 FLEETWOOD DR
EASLEY SC
29640-2022
US

IV. Provider business mailing address

209 TIMBER DR
PICKENS SC
29671-9010
US

V. Phone/Fax

Practice location:
  • Phone: 864-442-7701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36903
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: