Provider Demographics
NPI:1003167180
Name:DEAN, BILLIE EASON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BILLIE
Middle Name:EASON
Last Name:DEAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:SC
Mailing Address - Zip Code:29709-1702
Mailing Address - Country:US
Mailing Address - Phone:843-623-2632
Mailing Address - Fax:843-623-6031
Practice Address - Street 1:139 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:SC
Practice Address - Zip Code:29709-1702
Practice Address - Country:US
Practice Address - Phone:843-623-2632
Practice Address - Fax:843-623-6031
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8168183500000X
NC10901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist