Provider Demographics
NPI:1366786139
Name:COURTNEY, AARON C (RPH)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:C
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3595 HARDEN STREET EXT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6815
Mailing Address - Country:US
Mailing Address - Phone:803-799-1217
Mailing Address - Fax:803-799-8095
Practice Address - Street 1:3595 HARDEN STREET EXT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6815
Practice Address - Country:US
Practice Address - Phone:803-799-1217
Practice Address - Fax:803-799-8095
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC04210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC183500000XOtherPHARMACIST