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General NPI Number Information
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NPI Number | 1225550437
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Entity Type | Individual
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Provider Name | COURTNEY IZZO JARVIS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 1952 LONG GROVE DR STE 5
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-7579
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Country | US
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Telephone | 843-654-4013
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Fax | 843-654-4014
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Provider Business Mailing Address
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Address Line | 2028 BRICK KILN PKWY
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City | MOUNT PLEASANT
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State | SC
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Zip | 29466-8759
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Country | US
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Telephone | 774-239-4883
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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 | 37115
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License Number State | SC
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