Provider Demographics
NPI:1558828491
Name:DRUCKER, SAMUEL EDWARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:EDWARD
Last Name:DRUCKER
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 1:654 SUMTER HWY
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-4942
Mailing Address - Country:US
Mailing Address - Phone:843-356-0172
Mailing Address - Fax:
Practice Address - Street 1:654 SUMTER HWY
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-4942
Practice Address - Country:US
Practice Address - Phone:843-356-0172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist