Provider Demographics
NPI:1689971012
Name:CHRISTLEY, ANNA MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:ANNA MARIE
Middle Name:
Last Name:CHRISTLEY
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 1:1903 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-7760
Mailing Address - Country:US
Mailing Address - Phone:803-356-1001
Mailing Address - Fax:803-356-1006
Practice Address - Street 1:1903 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-7760
Practice Address - Country:US
Practice Address - Phone:803-356-1001
Practice Address - Fax:803-356-1006
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0010279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist