Provider Demographics
NPI:1841537263
Name:POWERS, GERALD LEROY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:LEROY
Last Name:POWERS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-3964
Mailing Address - Country:US
Mailing Address - Phone:843-545-8800
Mailing Address - Fax:
Practice Address - Street 1:810 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-3964
Practice Address - Country:US
Practice Address - Phone:843-545-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist