Individual
JESSICA PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 CHURCH ST, CONWAY, SC 29526-4824
(843) 248-6302
Mailing address
707 CHURCH ST, CONWAY, SC 29526-4824
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH42570
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH42570
SOUTH CAROLINA BOARD OF PHARMACY
SC
Enumeration date
07/23/2020
Last updated
07/23/2020
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