Provider Demographics
NPI:1508074196
Name:ASTLES, JOHN DREW (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DREW
Last Name:ASTLES
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 1:1132 CLUB TER
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-9581
Mailing Address - Country:US
Mailing Address - Phone:843-343-2989
Mailing Address - Fax:
Practice Address - Street 1:1132 CLUB TER
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-9581
Practice Address - Country:US
Practice Address - Phone:843-343-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC006065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist