Healthcare Provider Details

I. General information

NPI: 1023317997
Provider Name (Legal Business Name): JULIA SEABOLT PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SEMINOLE DR
GREENVILLE SC
29605-3017
US

IV. Provider business mailing address

6 SEMINOLE DR
GREENVILLE SC
29605-3017
US

V. Phone/Fax

Practice location:
  • Phone: 864-282-0022
  • Fax:
Mailing address:
  • Phone: 864-282-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number019050
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number010458
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number35601
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number010458
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number019050
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number35601
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: