Provider Demographics
NPI:1427396183
Name:BARCUS, HEATHER BOULWARE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:BOULWARE
Last Name:BARCUS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 MOSSY OAK CT
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-9721
Mailing Address - Country:US
Mailing Address - Phone:803-920-6223
Mailing Address - Fax:
Practice Address - Street 1:1138 SABBATH HOME RD SW
Practice Address - Street 2:
Practice Address - City:HOLDEN BEACH
Practice Address - State:NC
Practice Address - Zip Code:28462-5364
Practice Address - Country:US
Practice Address - Phone:910-846-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22483183500000X
SC13802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist