Provider Demographics
NPI:1225305659
Name:COKER, DAVID CRAIG (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CRAIG
Last Name:COKER
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 1:1440 BEN SAWYER BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5525
Mailing Address - Country:US
Mailing Address - Phone:843-388-2504
Mailing Address - Fax:843-856-0574
Practice Address - Street 1:1440 BEN SAWYER BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5525
Practice Address - Country:US
Practice Address - Phone:843-388-2504
Practice Address - Fax:843-856-0574
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist