MEDICARE: MRS. JANIENE TWARDY

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	13868	SC

General Provider Information

NPI Number	:	1588912729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANIENE TWARDY

Provider Business Mailing Address
First Line	:	140 SAYEBROOK PKWY
Second Line	:	T-2742
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-6834
Country	:	US
Telephone Number	:	843-294-6572
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 SAYEBROOK PKWY
Second Line	:	T-2742
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-6834
Country	:	US
Telephone Number	:	843-294-6572
Fax Number	:

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

Provider Enumeration Date	:	08/20/2012
Last Update Date	:	08/20/2012

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