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General NPI Number Information
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NPI Number | 1932616976
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Entity Type | Individual
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Provider Name | KATIE FRALIX JOHNSON PHARM D
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Gender | Female
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Dates
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Enumeration Date | 12/29/2017
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 776 DANIEL ELLIS DR
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City | CHARLESTON
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State | SC
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Zip | 29412-3094
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Country | US
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Telephone | 843-795-9554
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Fax | 843-795-2660
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Provider Business Mailing Address
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Address Line | 1025 RIVERLAND WOODS PL APT 403
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City | CHARLESTON
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State | SC
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Zip | 29412-4100
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Country | US
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Telephone | 843-532-8753
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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 | 37246
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License Number State | SC
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