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General NPI Number Information
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NPI Number | 1366888125
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Entity Type | Organization
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Legal Business Name | S.C. DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 3 CHARLESTON CENTER DR
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City | CHARLESTON
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State | SC
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Zip | 29401-1162
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Country | US
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Telephone | 843-579-4605
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Fax |
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Provider Business Mailing Address
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Address Line | 1751 CALHOUN ST
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City | COLUMBIA
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State | SC
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Zip | 29201-2606
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Country | US
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Telephone | 803-898-0813
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Fax |
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | CAROLINE SOJOURNER
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Credential | RPH
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Telephone | 803-898-0813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 14616
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License Number State | SC
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