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General NPI Number Information
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NPI Number | 1508168717
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Entity Type | Individual
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Provider Name | ERIKA ELIZABETH TILLERY PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 818 HARDEN ST
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City | COLUMBIA
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State | SC
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Zip | 29205-1002
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Country | US
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Telephone | 803-799-0043
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Fax |
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Provider Business Mailing Address
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Address Line | 132 CLUB DR
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-4144
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Country | US
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Telephone | 864-901-0193
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Fax |
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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 | 13096
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License Number State | SC
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