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General NPI Number Information
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NPI Number | 1134933864
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Entity Type | Individual
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Provider Name | DR. LAUREN JUSTINE MARY KOLLER
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 7771 PALMETTO COMMERCE PKWY
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-8859
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Country | US
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Telephone | 843-876-7074
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Fax | 843-876-0226
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Provider Business Mailing Address
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Address Line | 7771 PALMETTO COMMERCE PKWY STE 404
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-8860
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Country | US
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Telephone | 843-876-7074
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 60482
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License Number State | SC
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