Provider Demographics
NPI:1578084992
Name:BELLO, LARKIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LARKIN
Middle Name:
Last Name:BELLO
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 1:4 GWINN MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3927
Mailing Address - Country:US
Mailing Address - Phone:404-895-1080
Mailing Address - Fax:
Practice Address - Street 1:87 GARNER RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3175
Practice Address - Country:US
Practice Address - Phone:864-583-5428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC36871OtherPHARMACIST LICENSE