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Individual

SUE C BOURNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
140 S MAIN ST, SUMMERVILLE, SC 29483-6008
(843) 873-2531
(843) 873-4572
Mailing address
405 FRONT ST, GEORGETOWN, SC 29440-3735
(843) 527-6996

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5267
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5267
LICENSE
SC
Enumeration date
11/30/2006
Last updated
07/08/2007
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