Individual
DR. JENNIFER ROBIN ELLISOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH, PHARMD
Contact information
Practice address
101 PROFESSIONAL AVE, WEST COLUMBIA, SC 29169-4711
(803) 794-6440
(803) 739-1420
Mailing address
101 PROFESSIONAL AVE, WEST COLUMBIA, SC 29169-4711
(803) 794-6440
(803) 739-1420
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
009029
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009029
STATE LICENSE
SC
Enumeration date
05/09/2007
Last updated
07/08/2007
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