MEDICARE: CHRISTOPHER RYAN TEMPLETON CPHT

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
1	183700000X	Pharmacy Technician	19870	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	320101050753673	OTHER		PTCB
2	19870	OTHER	SC	SOUTH CAROLINA BOARD OF PHARMACY-PHARMACY TECHNICIAN REGISTRATION

General Provider Information

NPI Number	:	1174773691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER RYAN TEMPLETON CPHT

Provider Business Mailing Address
First Line	:	1547 GIBSON AVE
Second Line	:
City	:	SURFSIDE BEACH
State	:	SC
Zip	:	29575-5361
Country	:	US
Telephone Number	:	843-238-5159
Fax Number	:	843-238-8270

Provider Business Practice Location Address
First Line	:	1415 HIGHWAY 17 N
Second Line	:
City	:	SURFSIDE BEACH
State	:	SC
Zip	:	29575-6012
Country	:	US
Telephone Number	:	843-238-5159
Fax Number	:	843-238-8270

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2008
Last Update Date	:	10/06/2015

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