Healthcare Provider Details

I. General information

NPI: 1922389527
Provider Name (Legal Business Name): NICOLE BARTLETT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 DISCOVERY DR
BLUFFTON SC
29910-5173
US

IV. Provider business mailing address

27 DISCOVERY DR
BLUFFTON SC
29910-5173
US

V. Phone/Fax

Practice location:
  • Phone: 843-989-7030
  • Fax: 843-989-7032
Mailing address:
  • Phone: 843-989-7030
  • Fax: 843-989-7032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-24303
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20600
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36696
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: