Provider Demographics
NPI:1093483877
Name:GILLIAM, DARIUS T (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARIUS
Middle Name:T
Last Name:GILLIAM
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 1:1072 PIEDMONT GOLF COURSE RD UNIT 11A
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-7010
Mailing Address - Country:US
Mailing Address - Phone:864-466-7238
Mailing Address - Fax:
Practice Address - Street 1:2814 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2757
Practice Address - Country:US
Practice Address - Phone:864-224-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-05
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist