Healthcare Provider Details

I. General information

NPI: 1629746607
Provider Name (Legal Business Name): ALEXA ADAMS KNOX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 HIGHWAY 1 SOUTH
LUGOFF SC
29078-9086
US

IV. Provider business mailing address

2227 RIDGEWAY RD
LUGOFF SC
29078-9086
US

V. Phone/Fax

Practice location:
  • Phone: 803-408-9589
  • Fax:
Mailing address:
  • Phone: 803-416-2338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number43133
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: