Provider Demographics
NPI:1093017014
Name:ADDINGTON, MICHAEL TODD (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TODD
Last Name:ADDINGTON
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 1:501 N HARPER ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2337
Mailing Address - Country:US
Mailing Address - Phone:864-984-3026
Mailing Address - Fax:864-984-9257
Practice Address - Street 1:501 N HARPER ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2337
Practice Address - Country:US
Practice Address - Phone:864-984-3026
Practice Address - Fax:864-984-9257
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC011054183500000X
VA0202204712183500000X
NC16770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist