Healthcare Provider Details

I. General information

NPI: 1548787070
Provider Name (Legal Business Name): MEREDITH NYE KAYWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 ASHLEY PHOSPHATE RD
NORTH CHARLESTON SC
29418-2823
US

IV. Provider business mailing address

15 TYNTE ST
CHARLESTON SC
29407-7323
US

V. Phone/Fax

Practice location:
  • Phone: 843-767-4500
  • Fax:
Mailing address:
  • Phone: 678-779-4963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35851
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: