Healthcare Provider Details

I. General information

NPI: 1598013138
Provider Name (Legal Business Name): JENNIFER WATKINS OGBURN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 LONG POINT RD
MOUNT PLEASANT SC
29464-8216
US

IV. Provider business mailing address

640 LONG POINT RD
MOUNT PLEASANT SC
29464-8216
US

V. Phone/Fax

Practice location:
  • Phone: 843-881-5644
  • Fax: 843-881-5685
Mailing address:
  • Phone: 843-881-5644
  • Fax: 843-881-5685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13183
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: