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General NPI Number Information
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NPI Number | 1295611366
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Entity Type | Organization
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Legal Business Name | INNER PEACE HEALTH, LLC
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 515 E EMERALD LAKE DR
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City | SUMTER
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State | SC
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Zip | 29153
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Country | US
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Telephone | 803-468-0994
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Fax |
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Provider Business Mailing Address
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Address Line | 1165 BROAD ST
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City | SUMTER
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State | SC
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Zip | 29150-1932
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Country | US
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Telephone | 803-468-0994
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEJA JOHNSON
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Credential | PHARMD
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Telephone | 803-468-0994
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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 |
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License Number State |
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