MEDICARE: DR. DEANNA LUTZ HYDE 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	37389	SC

General Provider Information

NPI Number	:	1275052086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEANNA LUTZ HYDE PHARMD

Provider Business Mailing Address
First Line	:	5141 MIDDLETON VIEW DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-8517
Country	:	US
Telephone Number	:	843-446-3148
Fax Number	:

Provider Business Practice Location Address
First Line	:	3735 RENEE DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4109
Country	:	US
Telephone Number	:	843-273-7110
Fax Number	:

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

Provider Enumeration Date	:	09/12/2017
Last Update Date	:	06/16/2026

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