Provider Demographics
NPI:1215155783
Name:BADI, ANDREW DEAN (RPH)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DEAN
Last Name:BADI
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 1:868 KNOTTY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29527-3650
Mailing Address - Country:US
Mailing Address - Phone:518-852-2373
Mailing Address - Fax:
Practice Address - Street 1:350 FEASTER RD STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6176
Practice Address - Country:US
Practice Address - Phone:855-240-9368
Practice Address - Fax:864-558-0085
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16678183500000X
OK19401183500000X
ORRPH-0016630183500000X
TN41820183500000X
MI5302046283183500000X
NC28453183500000X
KS1-107212183500000X
LAPIC.022950183500000X
MST-16211183500000X
MD26970183500000X
TX61963183500000X
AL20251183500000X
VA202216894183500000X
NY040624183500000X
SC13539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist