Provider Demographics
NPI:1053561068
Name:CHAN, HELEN LAI-WA (PHARMD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:LAI-WA
Last Name:CHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 INVERNESS WAY
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-3119
Mailing Address - Country:US
Mailing Address - Phone:864-275-4606
Mailing Address - Fax:864-855-4776
Practice Address - Street 1:5991 CALHOUN MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3833
Practice Address - Country:US
Practice Address - Phone:864-306-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist