Healthcare Provider Details

I. General information

NPI: 1619410545
Provider Name (Legal Business Name): ASHLEY TYNER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY GODFREY

II. Dates (important events)

Enumeration Date: 11/26/2016
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N BELTLINE DR
FLORENCE SC
29501-7403
US

IV. Provider business mailing address

230 N BELTLINE DR
FLORENCE SC
29501-7403
US

V. Phone/Fax

Practice location:
  • Phone: 843-664-0909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26291
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36646
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: