Provider Demographics
NPI:1063758795
Name:STEELE, MARC S (RPH)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:S
Last Name:STEELE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 GUNSITE RD
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-6969
Mailing Address - Country:US
Mailing Address - Phone:803-482-3991
Mailing Address - Fax:
Practice Address - Street 1:4611 HARD SCRABBLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-8584
Practice Address - Country:US
Practice Address - Phone:803-736-9599
Practice Address - Fax:803-736-8839
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC004622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist