Healthcare Provider Details

I. General information

NPI: 1689142895
Provider Name (Legal Business Name): KIMBERLY M. HARKEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 E MAIN ST
MONCKS CORNER SC
29461-3616
US

IV. Provider business mailing address

402 E MAIN ST
MONCKS CORNER SC
29461-3616
US

V. Phone/Fax

Practice location:
  • Phone: 843-761-5255
  • Fax:
Mailing address:
  • Phone: 843-761-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10007
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: