Kelley Randall Castaneda, PHARMD
Individual provider Active NPI Pharmacist · Laurens, SC
NPI 1427340652 · NPPES record last updated May 5, 2011
Key facts
- NPI
- 1427340652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 12562 (SC)
- Practice address
- 901 E Main St
Laurens, SC 29360-3636 - Phone
- (864) 984-1492
- NPI assigned
- May 5, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12562 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ingles Markets Inc | Past | Accepting new patients | |
| Ingles Markets Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12562 | SC | Yes |
Addresses
Primary practice location
901 E Main St
Laurens, SC 29360-3636
Mailing address
901 E Main St
Laurens, SC 29360-3636
Phone (864) 984-1492
Other providers in Laurens, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.