MEDICARE: TERESA WEBB 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	004999	SC

General Provider Information

NPI Number	:	1770631533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA WEBB RPH

Provider Business Mailing Address
First Line	:	3400 WEST AVE
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6901
Country	:	US
Telephone Number	:	803-799-1700
Fax Number	:	803-254-3678

Provider Business Practice Location Address
First Line	:	201 CASHUA ST
Second Line	:	SUITE A
City	:	DARLINGTON
State	:	SC
Zip	:	29532-3301
Country	:	US
Telephone Number	:	843-393-6591
Fax Number	:

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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