Healthcare Provider Details

I. General information

NPI: 1508438656
Provider Name (Legal Business Name): NICHOLAS SILVESTRI PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COURTENAY DR
CHARLESTON SC
29425-8911
US

IV. Provider business mailing address

1108 BARBADOS WAY
CHARLESTON SC
29412-8649
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-5585
  • Fax:
Mailing address:
  • Phone: 843-283-1165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42973
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: