MEDICARE: MR. WOODROW WILSON COX JR. 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	3610	SC

General Provider Information

NPI Number	:	1962685560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WOODROW WILSON COX JR. RPH

Provider Business Mailing Address
First Line	:	9710 OCEAN HWY # 17
Second Line	:	UNIT 1
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-7585
Country	:	US
Telephone Number	:	843-235-4666
Fax Number	:	843-235-9630

Provider Business Practice Location Address
First Line	:	9710 OCEAN HWY # 17
Second Line	:	UNIT 1
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-7585
Country	:	US
Telephone Number	:	843-235-4666
Fax Number	:	843-235-9630

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

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	12/06/2007

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