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General NPI Number Information
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NPI Number | 1851548796
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Entity Type | Individual
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Provider Name | LANCE CURRY MCRAE
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Gender | Male
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 1292 S PLEASANTBURG DR
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City | GREENVILLE
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State | SC
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Zip | 29605-1329
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Country | US
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Telephone | 864-299-3141
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Fax |
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Provider Business Mailing Address
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Address Line | 741 WOODRUFF RD APT 2233
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City | GREENVILLE
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State | SC
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Zip | 29607-6809
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Country | US
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Telephone | 843-862-6560
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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 | 012206
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License Number State | SC
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