Healthcare Provider Details

I. General information

NPI: 1952704405
Provider Name (Legal Business Name): KATRINA SHIELDS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATRINA ROBINSON PHARM.D.

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 N MAIN ST
SUMMERVILLE SC
29483-7326
US

IV. Provider business mailing address

1120 N MAIN ST
SUMMERVILLE SC
29483-7326
US

V. Phone/Fax

Practice location:
  • Phone: 843-821-7537
  • Fax: 843-821-7929
Mailing address:
  • Phone: 843-821-7537
  • Fax: 843-821-7929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12753
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: