MEDICARE: DR. PATRICK RUNEY JR. PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13196	SC
2	183500000X	Pharmacist	21555	NC

General Provider Information

NPI Number	:	1093187742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK RUNEY JR. PHARMD

Provider Business Mailing Address
First Line	:	6251 HIGHWAY 162
Second Line	:
City	:	HOLLYWOOD
State	:	SC
Zip	:	29449-5782
Country	:	US
Telephone Number	:	843-564-5720
Fax Number	:	843-564-5721

Provider Business Practice Location Address
First Line	:	6251 HIGHWAY 162
Second Line	:
City	:	HOLLYWOOD
State	:	SC
Zip	:	29449-5782
Country	:	US
Telephone Number	:	843-564-5720
Fax Number	:	843-564-5721

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2015
Last Update Date	:	10/21/2015

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