Provider Demographics
NPI:1437408325
Name:MARTIN, LUCINDA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 AUGUSTA STREET
Mailing Address - Street 2:100
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-2938
Mailing Address - Country:US
Mailing Address - Phone:864-271-1973
Mailing Address - Fax:864-298-0263
Practice Address - Street 1:1922 AUGUSTA STREET
Practice Address - Street 2:100
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-2938
Practice Address - Country:US
Practice Address - Phone:864-271-1973
Practice Address - Fax:864-298-0263
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist