Provider Demographics
NPI:1265029367
Name:EVANS, CRAIG AUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:AUSTIN
Last Name:EVANS
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 1:111 HAVENSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-8292
Mailing Address - Country:US
Mailing Address - Phone:864-617-7452
Mailing Address - Fax:
Practice Address - Street 1:3501 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7515
Practice Address - Country:US
Practice Address - Phone:864-295-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist