=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962797852
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHRINA AMIN PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2011
-----------------------------------------------------
Last Update Date | 06/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 611 HIGHWAY 301 N
-----------------------------------------------------
City | DILLON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29536-2446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-774-3400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1001 N MAIN ST
-----------------------------------------------------
City | MULLINS
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29574-1505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 12813
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------