Healthcare Provider Details

I. General information

NPI: 1295168243
Provider Name (Legal Business Name): JOSEPH SIMON TAYLOR SR. PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 REMBERT DENNIS BLVD
MONCKS CORNER SC
29461
US

IV. Provider business mailing address

100 REMBERT DENNIS BLVD
MONCKS CORNER SC
29461
US

V. Phone/Fax

Practice location:
  • Phone: 843-761-8261
  • Fax: 843-761-6265
Mailing address:
  • Phone: 843-761-8261
  • Fax: 843-761-6265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14273
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: