Provider Demographics
NPI:1154800464
Name:LANGDALE, FAITH ALLISON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:ALLISON
Last Name:LANGDALE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4700
Mailing Address - Country:US
Mailing Address - Phone:843-655-3229
Mailing Address - Fax:
Practice Address - Street 1:9610 N KINGS HWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4006
Practice Address - Country:US
Practice Address - Phone:843-449-9671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist