Healthcare Provider Details

I. General information

NPI: 1487587937
Provider Name (Legal Business Name): TRISH MICHAELS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 FOLLY ROAD BLVD UNIT 427
CHARLESTON SC
29407-8319
US

IV. Provider business mailing address

35 FOLLY ROAD BLVD UNIT 427
CHARLESTON SC
29407-8319
US

V. Phone/Fax

Practice location:
  • Phone: 219-771-3239
  • Fax:
Mailing address:
  • Phone: 219-771-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number66697
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: