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General NPI Number Information
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NPI Number | 1275929218
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Entity Type | Organization
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Legal Business Name | DELTA OF ISLE OF PALMS LLC
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 1400 PALM BLVD
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City | ISLE OF PALMS
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State | SC
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Zip | 29451-2280
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Country | US
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Telephone | 843-885-8008
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Fax | 843-899-4970
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Provider Business Mailing Address
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Address Line | 402 E MAIN ST
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City | MONCKS CORNER
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State | SC
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Zip | 29461-3616
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Country | US
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Telephone | 843-761-5255
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Fax | 843-899-4970
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Authorized Official
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Title or Position | MANAGER
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Name | SHERRY PARSONS
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Credential |
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Telephone | 843-761-5255
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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 | 15854
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License Number State | SC
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