Provider Demographics
NPI:1851937155
Name:PERHAM, BARBARA ANNE (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANNE
Last Name:PERHAM
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 TWIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:SC
Mailing Address - Zip Code:29693-3251
Mailing Address - Country:US
Mailing Address - Phone:203-521-6774
Mailing Address - Fax:
Practice Address - Street 1:15740 N HIGHWAY 11 STE 2B
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:SC
Practice Address - Zip Code:29676-3262
Practice Address - Country:US
Practice Address - Phone:864-719-0050
Practice Address - Fax:864-719-0406
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28543183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
300101041151243OtherCPHT
SC28543OtherSC STATE LICENSE