Provider Demographics
NPI:1588226542
Name:MARSHALL, MILEKA (PHARM D)
Entity Type:Individual
Prefix:
First Name:MILEKA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MAGNOLIA TREE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-6746
Mailing Address - Country:US
Mailing Address - Phone:803-920-3453
Mailing Address - Fax:
Practice Address - Street 1:3700 TWO NOTCH RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2872
Practice Address - Country:US
Practice Address - Phone:803-786-0158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-30
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030296183500000X
SC37710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist