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NPI Code Detail

MEDICARE: KAITLIN PELL PHARMD

MEDICARE:   KAITLIN  PELL  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist35636SC

General Provider Information

NPI Number : 1144629627
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN PELL PHARMD
Provider Business Mailing Address
First Line : 102 BRENT FORD CIR
Second Line :
City : COLUMBIA
State : SC
Zip : 29212-1828
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7412 BROAD RIVER RD
Second Line :
City : IRMO
State : SC
Zip : 29063-9662
Country : US
Telephone Number : 803-749-3046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2014
Last Update Date : 08/20/2014

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Directions to “ KAITLIN PELL PHARMD” Practice Location

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