Individual
HANNAH GREEN FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
694 FAIRVIEW RD, SIMPSONVILLE, SC 29680-6708
(864) 963-4406
Mailing address
131 RIVERDALE RD, SIMPSONVILLE, SC 29680-7745
(803) 981-2887
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42611
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42611
SOUTH CAROLINE BOARD OF PHARMACY
SC
Enumeration date
08/04/2020
Last updated
08/04/2020
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