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General NPI Number Information
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NPI Number | 1154800464
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Entity Type | Individual
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Provider Name | FAITH ALLISON LANGDALE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 9610 N KINGS HWY
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4006
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Country | US
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Telephone | 843-449-9671
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Fax |
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Provider Business Mailing Address
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Address Line | 301 CLUB CIR
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4700
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Country | US
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Telephone | 843-655-3229
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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 | 37692
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License Number State | SC
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