Provider Demographics
NPI:1417241142
Name:ASH, BROOKE BIVENS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:BIVENS
Last Name:ASH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 LONG GROVE DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-9462
Mailing Address - Country:US
Mailing Address - Phone:843-388-8769
Mailing Address - Fax:
Practice Address - Street 1:1300 LONG GROVE DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-9462
Practice Address - Country:US
Practice Address - Phone:843-388-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-28
Last Update Date:2011-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist