=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104041003
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOANNE B EPLEY RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2600 BULL ST SCDHEC OPHP
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29201-1708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-898-8383
-----------------------------------------------------
Fax | 803-898-3335
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 186 RIVER BIRCH LN
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29206-4959
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-782-6172
-----------------------------------------------------
Fax | 803-782-0309
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 4564
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------