Healthcare Provider Details

I. General information

NPI: 1063734804
Provider Name (Legal Business Name): ROGER E FOSTER II PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2010
Last Update Date: 02/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 OAKLAND AVE
ROCK HILL SC
29732-3035
US

IV. Provider business mailing address

1008 OAKLAND AVE
ROCK HILL SC
29732-3035
US

V. Phone/Fax

Practice location:
  • Phone: 803-980-1350
  • Fax:
Mailing address:
  • Phone: 803-980-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12336
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: