Provider Demographics
NPI:1962542555
Name:SOX, MONETTE T (RPH)
Entity type:Individual
Prefix:MRS
First Name:MONETTE
Middle Name:T
Last Name:SOX
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 1:3065 MINERAL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-9610
Mailing Address - Country:US
Mailing Address - Phone:803-356-2875
Mailing Address - Fax:
Practice Address - Street 1:8500 FARROW ROAD BLDG 16
Practice Address - Street 2:SC DHEC CENTRAL PHARMACY
Practice Address - City:STATE PARK
Practice Address - State:SC
Practice Address - Zip Code:29147
Practice Address - Country:US
Practice Address - Phone:803-896-3808
Practice Address - Fax:803-896-6252
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5626183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist