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General NPI Number Information
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NPI Number | 1093194375
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Entity Type | Organization
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Legal Business Name | LOWCOUNTRY REMEDIES
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 775 SAINT JAMES AVE
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City | GOOSE CREEK
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State | SC
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Zip | 29445-2836
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Country | US
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Telephone | 843-695-8292
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Fax | 187-771-3776
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Provider Business Mailing Address
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Address Line | 775 B ST JAMES AVENUE
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City | GOOSE CREEK
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State | SC
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Zip | 29445
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Country | US
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Telephone | 843-695-8292
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Fax | 187-771-3776
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Authorized Official
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Title or Position | PHARMACIST
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Name | WILLIAM R CLAIR
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Credential | RPH
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Telephone | 843-695-8292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 15961
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License Number State | SC
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