Provider Demographics
NPI:1578019915
Name:EPTON, HEATHER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:EPTON
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:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:ESTILL
Mailing Address - State:SC
Mailing Address - Zip Code:29918-0335
Mailing Address - Country:US
Mailing Address - Phone:803-625-9001
Mailing Address - Fax:803-625-0577
Practice Address - Street 1:136 MARTIN L KING JR BLVD N
Practice Address - Street 2:
Practice Address - City:ESTILL
Practice Address - State:SC
Practice Address - Zip Code:29918-5146
Practice Address - Country:US
Practice Address - Phone:803-625-9001
Practice Address - Fax:803-625-0577
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC12776OtherSTATE BOARD PHARMACY LICENSE