Provider Demographics
NPI:1427394212
Name:MCDOWELL, AMANDA CHARITY
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHARITY
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SAINT JAMES AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2994
Mailing Address - Country:US
Mailing Address - Phone:843-569-7942
Mailing Address - Fax:843-569-0736
Practice Address - Street 1:208 SAINT JAMES AVE STE C
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2994
Practice Address - Country:US
Practice Address - Phone:843-569-7942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-24
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist