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Organization
PALMETTO SPECIALTY PHARM LLC
Active
Organization
PALMETTO SPECIALTY PHARM LLC
Active
Other names
Palmetto Pharm
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN JOSEPH FENNICK PHARMD (CEO)
(843) 972-7704
Entity
Organization
Contact information
Practice address
1200 TWO ISLAND CT UNIT B, MOUNT PLEASANT, SC 29466-7418
(843) 972-7704
(843) 972-9395
Mailing address
1200 TWO ISLAND CT UNIT B, MOUNT PLEASANT, SC 29466-7418
(843) 972-7704
(843) 972-9395
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20906
SOUTH CAROLINA PHARMACY LICENSE
SC
Enumeration date
10/27/2022
Last updated
10/27/2022
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