Healthcare Provider Details

I. General information

NPI: 1275933640
Provider Name (Legal Business Name): MICHAEL BLAIR WEST PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6057 WHITE HORSE RD
GREENVILLE SC
29611-3842
US

IV. Provider business mailing address

6057 WHITE HORSE RD
GREENVILLE SC
29611-3842
US

V. Phone/Fax

Practice location:
  • Phone: 864-295-0243
  • Fax: 864-295-1959
Mailing address:
  • Phone: 864-295-0243
  • Fax: 864-295-1959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35770
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: