Healthcare Provider Details

I. General information

NPI: 1740120005
Provider Name (Legal Business Name): JOE MAZUR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 ASHLEY AVE
CHARLESTON SC
29425-8907
US

IV. Provider business mailing address

1748 JAMES BASFORD PL
MT PLEASANT SC
29466-7041
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2300
  • Fax:
Mailing address:
  • Phone: 843-792-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number9513
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: