MEDICARE: DUNKLIN YODICE

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	60682	SC

General Provider Information

NPI Number	:	1629953393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUNKLIN YODICE

Provider Business Mailing Address
First Line	:	1377 HIDDEN LAKES DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-9471
Country	:	US
Telephone Number	:	843-530-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2035 SC-41
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-2946
Country	:	US
Telephone Number	:	843-971-6311
Fax Number	:

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

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	08/11/2025

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Directions to “ DUNKLIN YODICE ” Practice Location

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