Healthcare Provider Details

I. General information

NPI: 1891811097
Provider Name (Legal Business Name): DON A LUSK PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 MEMORIAL DR OCONEE MEM. HOSP. - DEPT. OF PHARMACY
SENECA SC
29672-9443
US

IV. Provider business mailing address

117 SITKA LN
LIBERTY SC
29657-4600
US

V. Phone/Fax

Practice location:
  • Phone: 864-885-7621
  • Fax: 864-885-7555
Mailing address:
  • Phone: 864-843-6031
  • Fax: 864-885-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9718
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: