Provider Demographics
NPI:1932680832
Name:BILICKE, IFE ABIGAIL (PHARMD)
Entity Type:Individual
Prefix:
First Name:IFE
Middle Name:ABIGAIL
Last Name:BILICKE
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 1:204 RED GLOBE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-7696
Mailing Address - Country:US
Mailing Address - Phone:716-242-9997
Mailing Address - Fax:
Practice Address - Street 1:334 E MARTINTOWN RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-4261
Practice Address - Country:US
Practice Address - Phone:803-441-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37872183500000X
GARPH030804183500000X
TX61783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH030804OtherSTATE LICENSE (GA)
TX61783OtherSTATE LICENSE (TX)
SC37872OtherSTATE LICENSE (SC)