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Individual

STACEY SCAGGS SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
101 HAMPTON AVE, PICKENS, SC 29671-2462
(864) 878-0599
Mailing address
4 KINGSDALE CT, SIMPSONVILLE, SC 29680-7641
(803) 215-1807

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37896
SC

Other

Enumeration date
09/21/2018
Last updated
09/21/2018
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