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NPI Code Detail

MEDICARE: DR. ASHLEY PERDUE JORDAN PHARMD

MEDICARE: DR. ASHLEY PERDUE JORDAN 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
1183500000XPharmacist35386SC

General Provider Information

NPI Number : 1982011839
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHLEY PERDUE JORDAN PHARMD
Provider Business Mailing Address
First Line : 1373 RIVER RD
Second Line :
City : JOHNS ISLAND
State : SC
Zip : 29455-8708
Country : US
Telephone Number : 843-992-9264
Fax Number :
Provider Business Practice Location Address
First Line : 3621 SAVANNAH HWY
Second Line :
City : JOHNS ISLAND
State : SC
Zip : 29455-7937
Country : US
Telephone Number : 843-571-0615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2014
Last Update Date : 08/24/2020

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