Provider Demographics
NPI:1275824765
Name:PERKINS, WILLIAM CLELLAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CLELLAN
Last Name:PERKINS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 SPRINGLAKE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-8836
Mailing Address - Country:US
Mailing Address - Phone:803-818-5304
Mailing Address - Fax:
Practice Address - Street 1:630 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-1605
Practice Address - Country:US
Practice Address - Phone:803-684-6931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist