Provider Demographics
NPI:1134464985
Name:CATES, GINGER
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:CATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 BROAD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-9656
Mailing Address - Country:US
Mailing Address - Phone:803-407-0436
Mailing Address - Fax:803-407-0662
Practice Address - Street 1:7320 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-9656
Practice Address - Country:US
Practice Address - Phone:803-407-0436
Practice Address - Fax:803-407-0662
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist