# PLANTATION PHARMACY AT ELLIS OAKS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255416616
- **Authorized official:** MS. DEBORAH DAPORE R.PH. (OWNER)
- **Authorized official phone:** (843) 795-9554

## Contact information

- **Practice address:** 776 DANIEL ELLIS DR, 2C, CHARLESTON, SC 29412-3094
- **Practice address phone:** (843) 795-9554
- **Practice address fax:** (843) 795-2660
- **Mailing address:** 776 DANIEL ELLIS DR, 2C, CHARLESTON, SC 29412-3094
- **Mailing address phone:** (843) 795-9554
- **Mailing address fax:** (843) 795-2660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 010727966 | SC | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 01/03/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 780107 | — | SC |