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NPI Code Detail

MEDICARE: MARY SUSAN RAPP

MEDICARE: MARY SUSAN RAPP
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
1183500000XPharmacist4935SC
2183500000XPharmacist12346GA
3183500000XPharmacist18140MA
4183500000XPharmacist1995DE
5183500000XPharmacistR1055NH

General Provider Information

NPI Number : 1295011211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY SUSAN RAPP
Provider Business Mailing Address
First Line : 125 TOWNE DR
Second Line :
City : BLUFFTON
State : SC
Zip : 29910-4203
Country : US
Telephone Number : 843-815-7070
Fax Number : 843-815-7078
Provider Business Practice Location Address
First Line : 125 TOWNE DR
Second Line :
City : BLUFFTON
State : SC
Zip : 29910-4203
Country : US
Telephone Number : 843-815-7070
Fax Number : 843-815-7078
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2011
Last Update Date : 10/24/2011

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1538636584 — KIRK KELLY SMITH
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Directions to “ MARY SUSAN RAPP ” Practice Location

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