Provider Demographics
NPI:1033685383
Name:CAUDLE, MADISON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MADISON
Middle Name:
Last Name:CAUDLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 EVESHAM DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5847
Mailing Address - Country:US
Mailing Address - Phone:843-906-3973
Mailing Address - Fax:
Practice Address - Street 1:389 JOHNNIE DODDS BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-2932
Practice Address - Country:US
Practice Address - Phone:843-972-4068
Practice Address - Fax:843-972-4069
Is Sole Proprietor?:No
Enumeration Date:2018-10-14
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist