Provider Demographics
NPI:1063853349
Name:STEADMAN, JUSTIN TYLER (PHARMD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:TYLER
Last Name:STEADMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1521
Mailing Address - Country:US
Mailing Address - Phone:864-877-3386
Mailing Address - Fax:
Practice Address - Street 1:320 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1521
Practice Address - Country:US
Practice Address - Phone:864-877-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist