Provider Demographics
NPI:1104106301
Name:TAYLOR, HEATHER HUGHES (PHARMD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:HUGHES
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 SPRUCE WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7826
Mailing Address - Country:US
Mailing Address - Phone:706-833-0022
Mailing Address - Fax:
Practice Address - Street 1:6090 GARNERS FERRY RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-0600
Practice Address - Country:US
Practice Address - Phone:803-783-3752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist