Healthcare Provider Details

I. General information

NPI: 1366706848
Provider Name (Legal Business Name): DAREEN ANTOUN DOUCHI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 STUART ST ROOM(S) #1-56 & 1-56A
COLUMBIA SC
29207-5700
US

IV. Provider business mailing address

4500 STUART ST ROOM(S) #1-56 & 1-56A
COLUMBIA SC
29207-5700
US

V. Phone/Fax

Practice location:
  • Phone: 803-751-2789
  • Fax:
Mailing address:
  • Phone: 802-751-2789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number12205
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: