Provider Demographics
NPI:1982129037
Name:PROPES, ANTHONY RYAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:RYAN
Last Name:PROPES
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 1:303 TULLYTON DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-7766
Mailing Address - Country:US
Mailing Address - Phone:678-920-3174
Mailing Address - Fax:
Practice Address - Street 1:3925 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5004
Practice Address - Country:US
Practice Address - Phone:864-288-8171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist