Provider Demographics
NPI:1386715431
Name:CYR, DAVID LEO (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEO
Last Name:CYR
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 1:1743 N FRASER ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-6407
Mailing Address - Country:US
Mailing Address - Phone:843-546-2222
Mailing Address - Fax:843-527-8300
Practice Address - Street 1:1743 N FRASER ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-6407
Practice Address - Country:US
Practice Address - Phone:843-546-2222
Practice Address - Fax:843-527-8300
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist