=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992358865
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRINDEL OGSTON LANCASTER PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2019
-----------------------------------------------------
Last Update Date | 07/19/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4600 HIGHWAY 9
-----------------------------------------------------
City | INMAN
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29349-8001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-814-3643
-----------------------------------------------------
Fax | 864-814-3711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 710 SWITZER GREEN POND RD
-----------------------------------------------------
City | WOODRUFF
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29388-9431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-398-7420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 42109
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------