# LOWCOUNTRY RHEUMATOLOGY PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LCR Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053617654
- **Authorized official:** BRANTLEY WESCOTT (PIC)
- **Authorized official phone:** (615) 301-5911

## Contact information

- **Practice address:** 9231 MEDICAL PLAZA DR STE A, NORTH CHARLESTON, SC 29406-9101
- **Practice address phone:** (843) 572-4840
- **Practice address fax:** (855) 378-1477
- **Mailing address:** 9231 MEDICAL PLAZA DR STE A, CHARLESTON, SC 29406-9101
- **Mailing address phone:** (843) 572-4840
- **Mailing address fax:** (855) 378-1477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 11282 | SC | Yes |

## Other

- **Enumeration date:** 01/31/2011
- **Last updated:** 02/16/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2128514 | PK | — |