Provider Demographics
NPI:1245968494
Name:FLUHARTY, KELSEY RAE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:RAE
Last Name:FLUHARTY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:RAE
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6047 VERMILION LOOP
Mailing Address - Street 2:
Mailing Address - City:GRANITEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29829-3259
Mailing Address - Country:US
Mailing Address - Phone:419-689-4770
Mailing Address - Fax:
Practice Address - Street 1:6047 VERMILION LOOP
Practice Address - Street 2:
Practice Address - City:GRANITEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29829-3259
Practice Address - Country:US
Practice Address - Phone:419-689-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist