Provider Demographics
NPI:1790471241
Name:GOFF, TRENTON WESLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRENTON
Middle Name:WESLEY
Last Name:GOFF
Suffix:
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 1:1100 TIGER BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-2664
Mailing Address - Country:US
Mailing Address - Phone:864-653-7962
Mailing Address - Fax:
Practice Address - Street 1:1100 TIGER BLVD
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2664
Practice Address - Country:US
Practice Address - Phone:864-653-7962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist