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General NPI Number Information
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NPI Number | 1639351521
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Entity Type | Individual
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Provider Name | CORINNE LEIGH RACE RPH
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Gender | Female
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 2907 HIGHWAY 160 W
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City | FORT MILL
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State | SC
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Zip | 29708-8491
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Country | US
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Telephone | 803-548-6495
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Fax |
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Provider Business Mailing Address
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Address Line | 5916 NUTHATCH CT
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City | CHARLOTTE
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State | NC
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Zip | 28277-5523
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Country | US
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Telephone | 516-662-0009
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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 | 13584
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License Number State | SC
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