Individual provider Active NPI

Avery Ethan Lambert, PHARMD

  • Pharmacist
  • Mullins, SC
National Provider Identifier
1154971133
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
42222 Issued in SC
Practice address
236 W McIntyre St
Mullins, SC 29574-3524
Phone
(843) 464-0372
Fax
(843) 464-2729
NPI assigned
Sep 12, 2019
Last updated
Sep 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42222 SC Primary

Addresses

Primary practice location

236 W McIntyre St
Mullins, SC 29574-3524

Mailing address

236 W McIntyre St
Mullins, SC 29574-3524
Phone (843) 464-0372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
42222SCMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1154971133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 W MCINTYRE ST",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295743524",
            "telephone_number": "843-464-0372",
            "fax_number": "843-464-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 W MCINTYRE ST",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295743524",
            "telephone_number": "843-464-0372",
            "fax_number": "843-464-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERT",
        "first_name": "AVERY",
        "middle_name": "ETHAN",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "42222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullins, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.