Individual
MARISSA HARTERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3312 DEVINE ST, COLUMBIA, SC 29205-1850
(803) 748-8858
Mailing address
3312 DEVINE ST, COLUMBIA, SC 29205-1850
(704) 661-0923
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
30084
NC
183500000X
Pharmacist
Primary
42595
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42595
PHARMACIST LICENSE
SC
Enumeration date
07/29/2020
Last updated
01/22/2021
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