Provider Demographics
NPI:1598043010
Name:BRINSON, HALEY EDWARDS (PHARMD)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:EDWARDS
Last Name:BRINSON
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 1:694 FAIRVIEW RD
Mailing Address - Street 2:T-1870
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-6708
Mailing Address - Country:US
Mailing Address - Phone:864-963-4406
Mailing Address - Fax:
Practice Address - Street 1:694 FAIRVIEW RD
Practice Address - Street 2:T-1870
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-6708
Practice Address - Country:US
Practice Address - Phone:864-963-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist