Healthcare Provider Details

I. General information

NPI: 1194962456
Provider Name (Legal Business Name): ASHLEY N CASTELVECCHI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY N SHORT

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 07/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 PARK CREEK DR PHARMACY-119
GREENVILLE SC
29605-4270
US

IV. Provider business mailing address

41 PARK CREEK DR PHARMACY-119
GREENVILLE SC
29605-4270
US

V. Phone/Fax

Practice location:
  • Phone: 864-299-1600
  • Fax:
Mailing address:
  • Phone: 864-299-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number014009
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number3791
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13982
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: