Provider Demographics
NPI:1487935797
Name:PRICE, PATRICIA DOROTHY (RPH)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DOROTHY
Last Name:PRICE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7581 REGINA CT
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-8005
Mailing Address - Country:US
Mailing Address - Phone:914-552-2368
Mailing Address - Fax:
Practice Address - Street 1:7581 REGINA CT
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-8005
Practice Address - Country:US
Practice Address - Phone:914-552-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025619183500000X
SC11347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist