Provider Demographics
NPI:1538462072
Name:CARTER, JUSTIN PALMER
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:PALMER
Last Name:CARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SNAPDRAGON CT STE A
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8343
Mailing Address - Country:US
Mailing Address - Phone:803-622-9976
Mailing Address - Fax:803-888-2089
Practice Address - Street 1:105 SNAPDRAGON CT STE A
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-8343
Practice Address - Country:US
Practice Address - Phone:803-345-9999
Practice Address - Fax:803-888-2089
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist