Provider Demographics
NPI:1487262036
Name:BEARD, LAUREN SIMONS (PHARMD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:SIMONS
Last Name:BEARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:SIMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 EDEN BROOK CT
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:SC
Mailing Address - Zip Code:29053-8259
Mailing Address - Country:US
Mailing Address - Phone:843-636-4292
Mailing Address - Fax:
Practice Address - Street 1:3217 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1847
Practice Address - Country:US
Practice Address - Phone:803-849-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42028183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist