Provider Demographics
NPI:1407999618
Name:KENNINGTON, CHRISTOPHER EVANS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EVANS
Last Name:KENNINGTON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 SAINT MICHAEL AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:SC
Mailing Address - Zip Code:29055-1127
Mailing Address - Country:US
Mailing Address - Phone:803-482-4570
Mailing Address - Fax:
Practice Address - Street 1:1073 W MEETING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2205
Practice Address - Country:US
Practice Address - Phone:803-285-2021
Practice Address - Fax:803-285-7990
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC10097OtherSC PHARMACIST LICENSE