Provider Demographics
NPI:1447557582
Name:CASSANO, JULIE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:CASSANO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 CANOPY CV
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9196
Mailing Address - Country:US
Mailing Address - Phone:843-795-1504
Mailing Address - Fax:
Practice Address - Street 1:915 FOLLY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3907
Practice Address - Country:US
Practice Address - Phone:843-795-5452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0010954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist