MEDICARE: PALMETTO PHARMACEUTICAL CARE

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	7244	SC

General Provider Information

NPI Number	:	1922292358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMETTO PHARMACEUTICAL CARE

Provider Business Mailing Address
First Line	:	245 SEVEN FARMS DR
Second Line	:	STE 110
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7553
Country	:	US
Telephone Number	:	843-377-8102
Fax Number	:	843-856-8788

Provider Business Practice Location Address
First Line	:	245 SEVEN FARMS DR
Second Line	:	STE 110
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7553
Country	:	US
Telephone Number	:	843-377-8102
Fax Number	:	843-856-8788

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	MRS. DENISE BROWN WYNDHAM
Credential	:	RPH
Telephone Number	:	843-377-8102

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	08/29/2007

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Directions to “PALMETTO PHARMACEUTICAL CARE ” Practice Location

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