Healthcare Provider Details

I. General information

NPI: 1881982007
Provider Name (Legal Business Name): VICTORIA LOWN ATKINS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E FRONT ST
IVA SC
29655-9089
US

IV. Provider business mailing address

518 E GREER ST
HONEA PATH SC
29654-1823
US

V. Phone/Fax

Practice location:
  • Phone: 643-486-1388
  • Fax: 643-482-2208
Mailing address:
  • Phone: 864-369-0707
  • Fax: 864-369-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number011768
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: