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Individual

ROBERT L COFFMAN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2709 CHURCH ST STE A, CONWAY, SC 29526-4440
(843) 365-0301
Mailing address
2647 OPHELIA WAY, MYRTLE BEACH, SC 29577-6788
(843) 293-0577

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
41934
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41934
REGISTERED PHARMACIST LICENCE
SC
01
RP037337L
REGISTERED PHARMACIST LICENCE
PA
Enumeration date
06/17/2019
Last updated
06/17/2019
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