Provider Demographics
NPI:1588031900
Name:PLAISTED, SPENCER (RPH)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:PLAISTED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2153 E MAIN ST
Mailing Address - Street 2:SUITE B9
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8724
Mailing Address - Country:US
Mailing Address - Phone:864-486-4706
Mailing Address - Fax:
Practice Address - Street 1:2153 E MAIN ST
Practice Address - Street 2:SUITE B9
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-8724
Practice Address - Country:US
Practice Address - Phone:864-486-4706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36254183500000X
NC25529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist