MEDICARE: ALISA CHRISTMAN 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
1	1835P1200X	Pharmacotherapy Pharmacist	10597	SC
2	1835P1200X	Pharmacotherapy Pharmacist	0202205307	VA

General Provider Information

NPI Number	:	1245220201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISA CHRISTMAN PHARMD

Provider Business Mailing Address
First Line	:	971 CLEARSPRING DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-9657
Country	:	US
Telephone Number	:	843-762-4109
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 RUTLEDGE ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8903
Country	:	US
Telephone Number	:	843-792-3377
Fax Number	:

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/08/2007

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