Provider Demographics
NPI:1972700508
Name:PIERCE, JUDITH M (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:M
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:ORAVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:1613 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5309
Mailing Address - Country:US
Mailing Address - Phone:302-540-0605
Mailing Address - Fax:
Practice Address - Street 1:1500 S IRBY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3408
Practice Address - Country:US
Practice Address - Phone:843-629-8427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist