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NPI Code Detail

MEDICARE: HEATHER MARIA CHITTAM PHARMD

MEDICARE: HEATHER MARIA CHITTAM 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
1183500000XPharmacist12681SC

General Provider Information

NPI Number : 1790083699
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER MARIA CHITTAM PHARMD
Provider Business Mailing Address
First Line : 1903 S LAKE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-7760
Country : US
Telephone Number : 803-356-1001
Fax Number : 803-356-1006
Provider Business Practice Location Address
First Line : 1903 S LAKE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-7760
Country : US
Telephone Number : 803-356-1001
Fax Number : 803-356-1006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2011
Last Update Date : 03/02/2011

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Directions to “ HEATHER MARIA CHITTAM PHARMD” Practice Location

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