MEDICARE: MRS. LILA F TRUSSLER 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	5888	SC

General Provider Information

NPI Number	:	1811197221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LILA F TRUSSLER RPH

Provider Business Mailing Address
First Line	:	918 HOUSTON NORTHCUTT BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3447
Country	:	US
Telephone Number	:	843-884-5144
Fax Number	:	843-884-7389

Provider Business Practice Location Address
First Line	:	918 HOUSTON NORTHCUTT BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3447
Country	:	US
Telephone Number	:	843-884-5144
Fax Number	:	843-884-7389

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

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	07/23/2007

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