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NPI Code Detail

MEDICARE: MRS. TERESA DIANNE SOLTIS RPH

MEDICARE: MRS. TERESA DIANNE SOLTIS RPH
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
1183500000XPharmacist10566SC

General Provider Information

NPI Number : 1497185409
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA DIANNE SOLTIS RPH
Provider Business Mailing Address
First Line : 650 ELLIS OAK DR
Second Line : ROOM 119
City : CHARLESTON
State : SC
Zip : 29412-3089
Country : US
Telephone Number : 843-876-2969
Fax Number : 843-876-2967
Provider Business Practice Location Address
First Line : 650 ELLIS OAK DR
Second Line : ROOM 119
City : CHARLESTON
State : SC
Zip : 29412-3089
Country : US
Telephone Number : 843-876-2969
Fax Number : 843-876-2967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2013
Last Update Date : 11/13/2013

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