Provider Demographics
NPI:1295103505
Name:BROWNLEE, DUSTY (PHARMD)
Entity type:Individual
Prefix:
First Name:DUSTY
Middle Name:
Last Name:BROWNLEE
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 1:10635 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-7610
Mailing Address - Country:US
Mailing Address - Phone:843-879-5150
Mailing Address - Fax:843-879-5151
Practice Address - Street 1:10635 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-7610
Practice Address - Country:US
Practice Address - Phone:843-879-5150
Practice Address - Fax:843-879-5151
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist