Provider Demographics
NPI:1942637541
Name:CANN, RYAN ELIC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ELIC
Last Name:CANN
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 1:1211 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5737
Mailing Address - Country:US
Mailing Address - Phone:864-987-1090
Mailing Address - Fax:864-987-5013
Practice Address - Street 1:1211 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5737
Practice Address - Country:US
Practice Address - Phone:864-987-1090
Practice Address - Fax:864-987-5013
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist