Provider Demographics
NPI:1164653762
Name:MCDUFFIE, LYNN FULBRIGHT (REG PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:FULBRIGHT
Last Name:MCDUFFIE
Suffix:
Gender:F
Credentials:REG PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E GREENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4837
Mailing Address - Country:US
Mailing Address - Phone:864-512-6410
Mailing Address - Fax:864-512-2784
Practice Address - Street 1:700 E GREENVILLE ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4837
Practice Address - Country:US
Practice Address - Phone:864-512-6410
Practice Address - Fax:864-512-2784
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC6852183500000X
GAGA15517183500000X
NCNC16126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist