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General NPI Number Information
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NPI Number | 1346636198
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Entity Type | Individual
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Provider Name | J. MICHAEL ROSS R.PH.
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Gender | Male
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 406 LINKS CROSSING DR
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-7618
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Country | US
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Telephone | 803-606-9000
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Fax | 803-786-8843
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Provider Business Mailing Address
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Address Line | 406 LINKS CROSSING DR
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-7618
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Country | US
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Telephone | 803-606-9000
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Fax | 803-786-8843
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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 | 004792
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License Number State | SC
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