Provider Demographics
NPI:1033133871
Name:SUMMERLIN, JOHN BARNWELL (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BARNWELL
Last Name:SUMMERLIN
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 1:103 BROMWICH DR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7127
Mailing Address - Country:US
Mailing Address - Phone:843-910-0649
Mailing Address - Fax:
Practice Address - Street 1:9275 MEDICAL PLAZA DR STE A
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9140
Practice Address - Country:US
Practice Address - Phone:843-266-6095
Practice Address - Fax:843-797-3637
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist