MEDICARE: MS. SUSAN CANDACE CONE RPH

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	5811	SC
2	183500000X	Pharmacist	21286	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21286	OTHER	NC	PHARMACIST LICENSE
2	5811	OTHER	SC	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1699068296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN CANDACE CONE RPH

Provider Business Mailing Address
First Line	:	1305 BELLE POINT DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-8268
Country	:	US
Telephone Number	:	704-214-3039
Fax Number	:

Provider Business Practice Location Address
First Line	:	2195 TEA PLANTER LN
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29466-7804
Country	:	US
Telephone Number	:	843-881-2583
Fax Number	:

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

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	06/01/2013

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