MEDICARE: MRS. MICHELLE HUDSON

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	12437	SC

General Provider Information

NPI Number	:	1124326731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE HUDSON

Provider Business Mailing Address
First Line	:	23 COVENTRY CT
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-5706
Country	:	US
Telephone Number	:	843-815-3867
Fax Number	:

Provider Business Practice Location Address
First Line	:	6315 JONATHAN FRANCIS SR RD
Second Line	:
City	:	ST. HELENA IS
State	:	SC
Zip	:	29920-5310
Country	:	US
Telephone Number	:	843-322-1872
Fax Number	:	843-838-7935

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

Provider Enumeration Date	:	03/05/2011
Last Update Date	:	06/07/2022

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