Healthcare Provider Details

I. General information

NPI: 1306133947
Provider Name (Legal Business Name): EILEEN DE BAUCHE WARD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2011
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 SE MAIN ST
SIMPSONVILLE SC
29681-3247
US

IV. Provider business mailing address

727 SE MAIN ST STE 300 & 320
SIMPSONVILLE SC
29681
US

V. Phone/Fax

Practice location:
  • Phone: 864-454-6484
  • Fax: 864-522-1175
Mailing address:
  • Phone: 864-454-6484
  • Fax: 864-522-1175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21826
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number13440
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: