Healthcare Provider Details

I. General information

NPI: 1962334896
Provider Name (Legal Business Name): ANSLEY DIRST OGLESBY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 REVOLUTIONARY TRL
FAIRFAX SC
29827-7109
US

IV. Provider business mailing address

641 PARKER RD
SYLVANIA GA
30467-5179
US

V. Phone/Fax

Practice location:
  • Phone: 803-632-1951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH035216
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67770
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: