Individual
DR. KANE VAUGHN SUMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
101 N MAIN STREET, PROSPERITY, SC 29127
(803) 364-2310
Mailing address
1131 HALFACRE RD, NEWBERRY, SC 29108-8196
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37689
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37689
SOUTH CAROLINA BOARD OF PHARMACY - PHARMACY LICENSE NUMBER
SC
Enumeration date
10/16/2018
Last updated
10/16/2018
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