Provider Demographics
NPI:1740529171
Name:MUSGROVE, BRIAN PAUL (RPH)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PAUL
Last Name:MUSGROVE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-1902
Mailing Address - Country:US
Mailing Address - Phone:864-984-7713
Mailing Address - Fax:864-984-6400
Practice Address - Street 1:106 FLEMING ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-1902
Practice Address - Country:US
Practice Address - Phone:864-984-7713
Practice Address - Fax:864-984-6400
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8172183500000X
VA0202009540183500000X
MD19515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist