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NPI Code Detail

MEDICARE: DR. JENNIFER IVEY FAHEY PHARMD

MEDICARE: DR. JENNIFER IVEY FAHEY 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
1183500000XPharmacist11853SC

General Provider Information

NPI Number : 1740587922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER IVEY FAHEY PHARMD
Provider Business Mailing Address
First Line : 1120 N MAIN ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-7326
Country : US
Telephone Number : 843-821-7537
Fax Number :
Provider Business Practice Location Address
First Line : 1120 N MAIN ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-7326
Country : US
Telephone Number : 843-821-7537
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 02/23/2011

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