Healthcare Provider Details

I. General information

NPI: 1922292358
Provider Name (Legal Business Name): PALMETTO PHARMACEUTICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 SEVEN FARMS DR STE 110
DANIEL ISLAND SC
29492-7553
US

IV. Provider business mailing address

245 SEVEN FARMS DR STE 110
DANIEL ISLAND SC
29492-7553
US

V. Phone/Fax

Practice location:
  • Phone: 843-377-8102
  • Fax: 843-856-8788
Mailing address:
  • Phone: 843-377-8102
  • Fax: 843-856-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7244
License Number StateSC

VIII. Authorized Official

Name: MRS. DENISE BROWN WYNDHAM
Title or Position: PHARMACIST IN CHARGE
Credential: RPH
Phone: 843-377-8102