Healthcare Provider Details

I. General information

NPI: 1992180749
Provider Name (Legal Business Name): KASEY TUCKER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E MCBEE AVE
GREENVILLE SC
29601-2940
US

IV. Provider business mailing address

400 E MCBEE AVE
GREENVILLE SC
29601-2940
US

V. Phone/Fax

Practice location:
  • Phone: 864-240-2020
  • Fax:
Mailing address:
  • Phone: 864-240-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36230
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: