Healthcare Provider Details

I. General information

NPI: 1598077992
Provider Name (Legal Business Name): REGINA MCQUEEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3403 FOREST DR
COLUMBIA SC
29204-4028
US

IV. Provider business mailing address

905 CORISON LOOP
COLUMBIA SC
29229-9390
US

V. Phone/Fax

Practice location:
  • Phone: 803-782-4027
  • Fax:
Mailing address:
  • Phone: 843-245-5574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number13145
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: