MEDICARE: KAREN D ANDERSON 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
1	183500000X	Pharmacist	6231	SC

General Provider Information

NPI Number	:	1578544433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN D ANDERSON RPH

Provider Business Mailing Address
First Line	:	257 CUMBERLAND DR
Second Line	:
City	:	MOORE
State	:	SC
Zip	:	29369-9722
Country	:	US
Telephone Number	:	864-587-6904
Fax Number	:

Provider Business Practice Location Address
First Line	:	6950 S PINE ST
Second Line	:
City	:	PACOLET
State	:	SC
Zip	:	29372-2243
Country	:	US
Telephone Number	:	864-474-1145
Fax Number	:	864-474-9973

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	12/23/2022

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