Provider Demographics
NPI:1184930703
Name:VANCLEAVE, DARLENE LAWSON (PHARMD)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:LAWSON
Last Name:VANCLEAVE
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 1:7900 GARNERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-4738
Mailing Address - Country:US
Mailing Address - Phone:803-695-1116
Mailing Address - Fax:803-695-1119
Practice Address - Street 1:7900 GARNERS FERRY RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-4738
Practice Address - Country:US
Practice Address - Phone:803-695-1116
Practice Address - Fax:803-695-1119
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist