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General NPI Number Information
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NPI Number | 1770950537
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Entity Type | Individual
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Provider Name | ELIZABETH BRAY EMBERTSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 300 S KINGS HWY
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-4102
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Country | US
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Telephone | 502-545-0395
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S KINGS HWY
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-4102
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Country | US
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Telephone | 502-545-0395
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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 | 24995
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 017720
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41967
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License Number State | SC
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