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General NPI Number Information
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NPI Number | 1811270184
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Entity Type | Individual
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Provider Name | SARAH RACHEL VICTORIA DEPTULA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 907 FOLLY RD
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City | CHARLESTON
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State | SC
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Zip | 29412-3919
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Country | US
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Telephone | 843-795-5452
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 MAXCY ST
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City | CHARLESTON
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State | SC
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Zip | 29412-2715
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Country | US
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Telephone | 843-637-1891
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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 | 35426
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License Number State | SC
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