Healthcare Provider Details

I. General information

NPI: 1770833105
Provider Name (Legal Business Name): ROBIN ELAINE MARCINKO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 E MONTAGUE AVE
CHARLESTON SC
29405
US

IV. Provider business mailing address

1506 E MONTAGUE AVE
CHARLESTON SC
29405
US

V. Phone/Fax

Practice location:
  • Phone: 843-554-8753
  • Fax: 843-554-6154
Mailing address:
  • Phone: 843-554-8753
  • Fax: 843-554-6154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number008540
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: