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Individual

KATIE FOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1600 10TH AVE, CONWAY, SC 29526-4112
(843) 248-5015
Mailing address
150 SHERWOOD DR, CONWAY, SC 29526-3165
(843) 602-5283

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13767
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13767
BOARD OF PHARMACY
SC
Enumeration date
05/11/2018
Last updated
10/08/2019
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