Provider Demographics
NPI:1982952974
Name:STROUD, DANIELLE (RPH)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:STROUD
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 1:1211 HIGHWAY 301 N
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-2463
Mailing Address - Country:US
Mailing Address - Phone:843-774-5616
Mailing Address - Fax:
Practice Address - Street 1:1211 HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2463
Practice Address - Country:US
Practice Address - Phone:843-774-5616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist