Provider Demographics
NPI:1629163688
Name:SPIRES, KAY J (RPH)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:J
Last Name:SPIRES
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 1:1804 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-3324
Mailing Address - Country:US
Mailing Address - Phone:843-248-1500
Mailing Address - Fax:843-488-5905
Practice Address - Street 1:1804 MAIN ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-3324
Practice Address - Country:US
Practice Address - Phone:843-248-1500
Practice Address - Fax:843-488-5905
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist