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NPI Code Detail

MEDICARE: DR. THOMAS JURASKO PD

MEDICARE:  DR. THOMAS  JURASKO  PD
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
1183500000XPharmacist8459SC

General Provider Information

NPI Number : 1174740690
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS JURASKO PD
Provider Business Mailing Address
First Line : 315 MUIRFIELD RD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-5334
Country : US
Telephone Number : 843-215-6686
Fax Number :
Provider Business Practice Location Address
First Line : 1610 HIGHWAY 17 BUSINESS S
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29575
Country : US
Telephone Number : 843-650-4536
Fax Number : 843-650-4536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 03/17/2010

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Directions to “ DR. THOMAS JURASKO PD” Practice Location

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