Healthcare Provider Details

I. General information

NPI: 1073473393
Provider Name (Legal Business Name): MARIBETH BRUNE KOWALSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 EVE CRK
BEAUFORT SC
29906-9164
US

IV. Provider business mailing address

88 EVE CRK
BEAUFORT SC
29906-9164
US

V. Phone/Fax

Practice location:
  • Phone: 843-929-2185
  • Fax:
Mailing address:
  • Phone: 843-929-2185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number008525
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: