Provider Demographics
NPI:1215525761
Name:MANEY, JUDY ESTES (RPH)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ESTES
Last Name:MANEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 LAURENS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2999
Mailing Address - Country:US
Mailing Address - Phone:864-297-3175
Mailing Address - Fax:
Practice Address - Street 1:1908 LAURENS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2999
Practice Address - Country:US
Practice Address - Phone:864-297-3175
Practice Address - Fax:864-288-9218
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty