Provider Demographics
NPI:1508238965
Name:LEMON, TRAVIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:
Last Name:LEMON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 WINNOWING WAY
Mailing Address - Street 2:APT 412
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7523
Mailing Address - Country:US
Mailing Address - Phone:315-334-3034
Mailing Address - Fax:
Practice Address - Street 1:1676 N HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3310
Practice Address - Country:US
Practice Address - Phone:843-884-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist