Provider Demographics
NPI:1619397668
Name:LAWHON, STANLEY GARDNER (RPH)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:GARDNER
Last Name:LAWHON
Suffix:
Gender:M
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:PO BOX 1159
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-1159
Mailing Address - Country:US
Mailing Address - Phone:843-886-0787
Mailing Address - Fax:
Practice Address - Street 1:3951 W ASHLEY CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-9156
Practice Address - Country:US
Practice Address - Phone:843-763-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9997183500000X
NC9415183500000X
FLPS22881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist