Provider Demographics
NPI:1366788630
Name:NEWTON, NATHAN S JR (PHARM D, R PH)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:S
Last Name:NEWTON
Suffix:JR
Gender:M
Credentials:PHARM D, R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 BEN SAWYER BLVD
Mailing Address - Street 2:PUBLIX PHARMACY 1055
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4574
Mailing Address - Country:US
Mailing Address - Phone:843-856-3187
Mailing Address - Fax:
Practice Address - Street 1:1435 BEN SAWYER BLVD
Practice Address - Street 2:PUBLIX PHARMACY 1055
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4574
Practice Address - Country:US
Practice Address - Phone:843-856-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2012-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist