Healthcare Provider Details

I. General information

NPI: 1285710780
Provider Name (Legal Business Name): WILLIAM RICHARD HIGH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 SPARTANBURG HWY
LYMAN SC
29365-1808
US

IV. Provider business mailing address

181 VAUGHN RD
DUNCAN SC
29334-9604
US

V. Phone/Fax

Practice location:
  • Phone: 864-439-6127
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5472
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: