Healthcare Provider Details

I. General information

NPI: 1881430551
Provider Name (Legal Business Name): CASSANDRA ANN TWISDALE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSANDRA ANN GREBAS

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GROVE RD
GREENVILLE SC
29605-4210
US

IV. Provider business mailing address

112 LYNN ESTATE RD
HENDERSONVILLE NC
28792-7975
US

V. Phone/Fax

Practice location:
  • Phone: 864-522-3340
  • Fax:
Mailing address:
  • Phone: 804-337-2920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60191
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: