Provider Demographics
NPI:1548693658
Name:GRESHAM, COURTNEY SEXTON (PHARMD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SEXTON
Last Name:GRESHAM
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 1:130 BULL POINT DR
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:SC
Mailing Address - Zip Code:29940-2305
Mailing Address - Country:US
Mailing Address - Phone:843-876-0199
Mailing Address - Fax:843-985-4218
Practice Address - Street 1:457 JESSEN LN STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492-7987
Practice Address - Country:US
Practice Address - Phone:843-971-5492
Practice Address - Fax:843-849-5591
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist