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
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20906
PHARMACY LICENSE
SC
Enumeration date
10/14/2022
Last updated
05/20/2024
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