MEDICARE: MR. LEWIS DARWIN WALDREP RPH

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	183500000X	Pharmacist	4908	SC

General Provider Information

NPI Number	:	1184960239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEWIS DARWIN WALDREP RPH

Provider Business Mailing Address
First Line	:	9710 OCEAN HWY UNIT 2
Second Line	:
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-7585
Country	:	US
Telephone Number	:	803-235-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	9710 OCEAN HWY UNIT 2
Second Line	:
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-7585
Country	:	US
Telephone Number	:	803-235-0580
Fax Number	:

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

Provider Enumeration Date	:	12/18/2012
Last Update Date	:	12/18/2012

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