Healthcare Provider Details

I. General information

NPI: 1417231150
Provider Name (Legal Business Name): HEATHER RAE PASCHAL PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MEMORIAL LN
GEORGETOWN SC
29440-3311
US

IV. Provider business mailing address

1828 BELLE CHEZ
MOUNT PLEASANT SC
29464-7500
US

V. Phone/Fax

Practice location:
  • Phone: 843-545-9292
  • Fax: 843-520-4345
Mailing address:
  • Phone: 843-325-7177
  • Fax: 843-520-4345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12990
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: