Provider Demographics
NPI:1144758681
Name:HARLEY, CAMDEN JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAMDEN
Middle Name:JAMES
Last Name:HARLEY
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 1:110 BREAKERS DR UNIT 522
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4419
Mailing Address - Country:US
Mailing Address - Phone:724-600-5625
Mailing Address - Fax:
Practice Address - Street 1:3701 N KINGS HWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-2977
Practice Address - Country:US
Practice Address - Phone:843-448-9104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-29
Last Update Date:2017-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist