Provider Demographics
NPI:1962801621
Name:GANDY, JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:GANDY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PALM BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-2280
Mailing Address - Country:US
Mailing Address - Phone:843-885-8008
Mailing Address - Fax:843-885-8009
Practice Address - Street 1:1400 PALM BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:ISLE OF PALMS
Practice Address - State:SC
Practice Address - Zip Code:29451-2280
Practice Address - Country:US
Practice Address - Phone:843-885-8008
Practice Address - Fax:843-885-8009
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist