Provider Demographics
NPI:1235235482
Name:HAMILTON, PENNYE MUREAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PENNYE
Middle Name:MUREAN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5519
Mailing Address - Country:US
Mailing Address - Phone:803-736-7344
Mailing Address - Fax:803-751-2048
Practice Address - Street 1:4500 STUART STREET
Practice Address - Street 2:MONCRIEF ARMY COMMUNITY HOSP
Practice Address - City:FORT JACKSON
Practice Address - State:SC
Practice Address - Zip Code:29207-5720
Practice Address - Country:US
Practice Address - Phone:803-751-2689
Practice Address - Fax:803-751-2048
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist