Provider Demographics
NPI:1710237243
Name:BYRD, BRAUDY EMERSON III (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRAUDY
Middle Name:EMERSON
Last Name:BYRD
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 MELODY LANE
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550
Mailing Address - Country:US
Mailing Address - Phone:843-478-3057
Mailing Address - Fax:803-934-1810
Practice Address - Street 1:41 E. CALHOUN ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150
Practice Address - Country:US
Practice Address - Phone:803-418-0919
Practice Address - Fax:803-934-1810
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist