Provider Demographics
NPI:1508183054
Name:BAKER, VERA TUMBLING (RPH)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:TUMBLING
Last Name:BAKER
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 1:1215 LONGREEN PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7828
Mailing Address - Country:US
Mailing Address - Phone:803-462-3726
Mailing Address - Fax:803-462-9401
Practice Address - Street 1:1215 LONGREEN PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7828
Practice Address - Country:US
Practice Address - Phone:803-462-3726
Practice Address - Fax:803-462-9401
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist