Healthcare Provider Details

I. General information

NPI: 1750127163
Provider Name (Legal Business Name): ANTHONY D ESPOSITO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2024
Last Update Date: 07/04/2024
Certification Date: 07/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 RICE AVE
UNION SC
29379-1840
US

IV. Provider business mailing address

100 MCNEASE ST
UNION SC
29379-3023
US

V. Phone/Fax

Practice location:
  • Phone: 864-427-7668
  • Fax:
Mailing address:
  • Phone: 864-491-0472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60217
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: