Provider Demographics
NPI:1265868046
Name:STIREWALT, ASHLEY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:STIREWALT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-7595
Mailing Address - Country:US
Mailing Address - Phone:803-532-5226
Mailing Address - Fax:803-532-5356
Practice Address - Street 1:115 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-7595
Practice Address - Country:US
Practice Address - Phone:803-532-5226
Practice Address - Fax:803-532-5356
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist