MEDICARE: DR. COREY RICHARD PERROTTE PHARMD

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	42828	SC

General Provider Information

NPI Number	:	1952993693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COREY RICHARD PERROTTE PHARMD

Provider Business Mailing Address
First Line	:	65 SYCAMORE AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-6774
Country	:	US
Telephone Number	:	843-571-4461
Fax Number	:

Provider Business Practice Location Address
First Line	:	366 MATUSKOVIC DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-8213
Country	:	US
Telephone Number	:	412-478-7291
Fax Number	:

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

Provider Enumeration Date	:	02/04/2021
Last Update Date	:	03/03/2021

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Directions to “ DR. COREY RICHARD PERROTTE PHARMD” Practice Location

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