Healthcare Provider Details

I. General information

NPI: 1124377759
Provider Name (Legal Business Name): WENDY M KNOX PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 GARNERS FERRY RD
COLUMBIA SC
29209-2666
US

IV. Provider business mailing address

1456 RIDGE RD
HOPKINS SC
29061-8439
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-6605
  • Fax:
Mailing address:
  • Phone: 803-269-3124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number8143
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: