Individual
LANE MADISON HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
616 S WALNUT ST., PAMPLICO, SC 29583
(843) 493-2311
Mailing address
2051 BLYTHEWOOD CROSSING LN APT 622, BLYTHEWOOD, SC 29016-7158
(864) 238-9137
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42106
SC
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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