Provider Demographics
NPI:1376889600
Name:CHAPMAN, ROBERT WAYNE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WAYNE
Last Name:CHAPMAN
Suffix:JR
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 1:1009 LAKE MURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2824
Mailing Address - Country:US
Mailing Address - Phone:803-749-7485
Mailing Address - Fax:803-749-7488
Practice Address - Street 1:1009 LAKE MURRAY BLVD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2824
Practice Address - Country:US
Practice Address - Phone:803-749-7485
Practice Address - Fax:803-749-7488
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC796433Medicaid