MEDICARE: DR. STEPHANIE CHAYCE VANCE-CROTTS

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	35741	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35741	OTHER	SC	PHARMACY LICENSE

General Provider Information

NPI Number	:	1568819340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE CHAYCE VANCE-CROTTS

Provider Business Mailing Address
First Line	:	3915 N KINGS HWY
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-2742
Country	:	US
Telephone Number	:	843-353-5589
Fax Number	:	843-353-5588

Provider Business Practice Location Address
First Line	:	3915 N KINGS HWY
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-2742
Country	:	US
Telephone Number	:	843-353-5589
Fax Number	:	843-353-5588

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

Provider Enumeration Date	:	05/20/2016
Last Update Date	:	11/05/2025

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