Provider Demographics
NPI:1235437286
Name:LEE, MAURICE A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:A
Last Name:LEE
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 1:1290 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-3567
Mailing Address - Country:US
Mailing Address - Phone:803-531-6115
Mailing Address - Fax:803-531-6659
Practice Address - Street 1:1290 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-3567
Practice Address - Country:US
Practice Address - Phone:803-531-6115
Practice Address - Fax:803-531-6659
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist