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General NPI Number Information
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NPI Number | 1699486324
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Entity Type | Individual
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Provider Name | JASPER DEAN WOLFE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 9 CORPORATE PKWY
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City | GOOSE CREEK
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State | SC
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Zip | 29445-7145
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Country | US
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Telephone | 843-572-3237
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 DUNWICK DR
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City | JOHNS ISLAND
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State | SC
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Zip | 29455-8439
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Country | US
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Telephone | 412-977-9598
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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 | 43749
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License Number State | SC
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