Provider Demographics
NPI:1356458251
Name:WARTICK, RICHARD DEAN
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DEAN
Last Name:WARTICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1022
Mailing Address - Country:US
Mailing Address - Phone:843-836-2164
Mailing Address - Fax:843-846-8312
Practice Address - Street 1:211 PAIGE POINT ROAD
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:SC
Practice Address - Zip Code:29941-0008
Practice Address - Country:US
Practice Address - Phone:843-846-8148
Practice Address - Fax:843-846-8312
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC011183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist