Provider Demographics
NPI:1467016634
Name:GAMBLE, DELICIA H (PHARMD, MHA)
Entity Type:Individual
Prefix:DR
First Name:DELICIA
Middle Name:H
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:PHARMD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-0188
Mailing Address - Country:US
Mailing Address - Phone:803-250-1283
Mailing Address - Fax:800-781-1997
Practice Address - Street 1:7 MEDICAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-3604
Practice Address - Fax:803-434-3030
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36202183500000X, 1835P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0200XPharmacy Service ProvidersPharmacistPediatrics
No183500000XPharmacy Service ProvidersPharmacist