MEDICARE: DR. CAITLIN HUGGINS

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	RP0009338	WV
2	183500000X	Pharmacist	38017	SC

General Provider Information

NPI Number	:	1225509672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAITLIN HUGGINS

Provider Business Mailing Address
First Line	:	4401 HIGHWAY 17 S
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-5254
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 HIGHWAY 17 S
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-5254
Country	:	US
Telephone Number	:	843-272-8884
Fax Number	:

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

Provider Enumeration Date	:	12/11/2018
Last Update Date	:	12/11/2018

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