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General NPI Number Information
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NPI Number | 1467016634
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Entity Type | Individual
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Provider Name | DELICIA H GAMBLE PHARMD, MHA
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Gender | Female
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Dates
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Enumeration Date | 04/23/2019
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 7 MEDICAL PARK DRIVE
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City | COLUMBIA
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State | SC
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Zip | 29203
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Country | US
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Telephone | 803-434-3604
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Fax | 803-434-3030
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-0188
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Country | US
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Telephone | 803-250-1283
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Fax | 800-781-1997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 36202
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1835P0200X
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Taxonomy Name | Pediatric Pharmacist
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License Number | 36202
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License Number State | SC
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