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General NPI Number Information
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NPI Number | 1215630066
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Entity Type | Individual
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Provider Name | JERRI LOVE RPH
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Gender | Female
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 4875 OLD YORK RD
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City | ROCK HILL
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State | SC
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Zip | 29732-8127
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Country | US
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Telephone | 803-323-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 5405 HUDSON RD
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City | CLOVER
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State | SC
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Zip | 29710-7832
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Country | US
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Telephone | 972-679-1007
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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 | 10947
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License Number State | SC
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