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General NPI Number Information
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NPI Number | 1558799312
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Entity Type | Individual
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Provider Name | TAMARA DEAN MCCOLLUM RPH
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Gender | Female
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 7 HARBOUR VIEW DR
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City | SALEM
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State | SC
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Zip | 29676-4513
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Country | US
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Telephone | 864-704-7910
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HARBOUR VIEW DR
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City | SALEM
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State | SC
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Zip | 29676-4513
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Country | US
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Telephone | 864-704-7910
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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 | 11376
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License Number State | SC
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