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NPI Code Detail

MEDICARE: DR. DANA RENEE ROBERTSON PHARMD

MEDICARE:  DR. DANA RENEE ROBERTSON  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
1183500000XPharmacist12964SC

General Provider Information

NPI Number : 1255638458
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANA RENEE ROBERTSON PHARMD
Provider Business Mailing Address
First Line : 7412 BROAD RIVER RD
Second Line :
City : IRMO
State : SC
Zip : 29063-9662
Country : US
Telephone Number : 803-749-3046
Fax Number :
Provider Business Practice Location Address
First Line : 7412 BROAD RIVER RD
Second Line :
City : IRMO
State : SC
Zip : 29063-9662
Country : US
Telephone Number : 803-749-3046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2011
Last Update Date : 02/24/2011

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Directions to “ DR. DANA RENEE ROBERTSON PHARMD” Practice Location

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