Provider Demographics
NPI:1679972327
Name:DESAI, USHMA (PHARMD)
Entity Type:Individual
Prefix:
First Name:USHMA
Middle Name:
Last Name:DESAI
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 1:100 BENNINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-4007
Mailing Address - Country:US
Mailing Address - Phone:864-631-7243
Mailing Address - Fax:
Practice Address - Street 1:100 BENNINGTON WAY
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-4007
Practice Address - Country:US
Practice Address - Phone:864-631-7243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14127183500000X
TN37679183500000X
VA0202212553183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist