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General NPI Number Information
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NPI Number | 1992008650
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Entity Type | Organization
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Legal Business Name | FAMILY PHARMACY AT WCH
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 01/17/2011
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Provider Practice Location Address
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Address Line | 4070 HIGHWAY 17
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City | MURRELLS INLET
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State | SC
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Zip | 29576-5033
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Country | US
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Telephone | 843-652-1545
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Fax |
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Provider Business Mailing Address
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Address Line | 4070 HIGHWAY 17
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City | MURRELLS INLET
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State | SC
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Zip | 29576-5033
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Country | US
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Telephone | 843-652-1545
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Fax |
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Authorized Official
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Title or Position | CHEIF OPERATIONS OFFICER
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Name | GAYLE RESETAR
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Credential |
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Telephone | 843-652-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 11277
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License Number State | SC
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