Healthcare Provider Details
I. General information
NPI: 1770030983
Provider Name (Legal Business Name): STARCIA RENEE MCNEILL PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/06/2016
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1506 E MONTAGUE AVE
NORTH CHARLESTON SC
29405-5301
US
IV. Provider business mailing address
301D N MAIN ST
SUMMERVILLE SC
29483-6417
US
V. Phone/Fax
- Phone: 843-554-8867
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | PH36568 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | PH233831 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: