Provider Demographics
NPI:1962061341
Name:HALLIDAY, KAITLYN GAINEY (PHARMD)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:GAINEY
Last Name:HALLIDAY
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 STRATTON DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8500
Mailing Address - Country:US
Mailing Address - Phone:843-858-2583
Mailing Address - Fax:
Practice Address - Street 1:2014 S IRBY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3420
Practice Address - Country:US
Practice Address - Phone:843-292-0307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist