Individual
PROF. KERMIT RANDY TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1401 MAIN ST, CONWAY, SC 29526-3568
(843) 248-4609
Mailing address
1401 MAIN ST, CONWAY, SC 29526-3568
(843) 248-4609
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6624
SC
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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