Healthcare Provider Details

I. General information

NPI: 1699800946
Provider Name (Legal Business Name): DAVID DEEN PHARM.D., BCCCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 BEE ST
CHARLESTON SC
29401
US

IV. Provider business mailing address

102 S AINSDALE DR
CHARLESTON SC
29414-7365
US

V. Phone/Fax

Practice location:
  • Phone: 843-789-7503
  • Fax:
Mailing address:
  • Phone: 912-659-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number30218
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: