MEDICARE: LISA FITZGERALD HONEYCUTT 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	8286	SC

General Provider Information

NPI Number	:	1861658023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA FITZGERALD HONEYCUTT RPH

Provider Business Mailing Address
First Line	:	729 CROSSROADS PLZ
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8017
Country	:	US
Telephone Number	:	803-547-6100
Fax Number	:	803-547-7720

Provider Business Practice Location Address
First Line	:	729 CROSSROADS PLZ
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8017
Country	:	US
Telephone Number	:	803-547-6100
Fax Number	:	803-547-7720

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

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	08/06/2008

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