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General NPI Number Information
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NPI Number | 1548568017
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Entity Type | Individual
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Provider Name | AMELIA B GORSUCH RPH
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Gender | Female
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 1120 N MAIN ST WALGREENS PHARMACY
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City | SUMMERVILLE
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State | SC
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Zip | 29483-7326
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Country | US
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Telephone | 843-821-7537
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 N MAIN ST WALGREENS PHARMACY
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City | SUMMERVILLE
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State | SC
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Zip | 29483-7326
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Country | US
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Telephone | 843-821-7537
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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 | 10559
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12602
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH44722
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License Number State | CA
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