Provider Demographics
NPI:1598013112
Name:MCCALL, BRENDA B (BS)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:B
Last Name:MCCALL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 OLD FARRS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-6622
Mailing Address - Country:US
Mailing Address - Phone:864-905-4448
Mailing Address - Fax:864-246-7712
Practice Address - Street 1:7 FARRS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-1901
Practice Address - Country:US
Practice Address - Phone:864-246-1528
Practice Address - Fax:864-246-7712
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist