Provider Demographics
NPI:1558736876
Name:MCDUFFIE, RYAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MCDUFFIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BATESBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29006-1732
Mailing Address - Country:US
Mailing Address - Phone:803-532-6581
Mailing Address - Fax:803-532-0109
Practice Address - Street 1:501 W RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:BATESBURG
Practice Address - State:SC
Practice Address - Zip Code:29006-1732
Practice Address - Country:US
Practice Address - Phone:803-532-6581
Practice Address - Fax:803-532-0109
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist