Provider Demographics
NPI:1639451156
Name:PARNELL, KEVIN L (RPH)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:L
Last Name:PARNELL
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 1:774 S SHELMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7625
Mailing Address - Country:US
Mailing Address - Phone:843-388-1550
Mailing Address - Fax:843-388-1549
Practice Address - Street 1:774 S SHELMORE BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7625
Practice Address - Country:US
Practice Address - Phone:843-388-1550
Practice Address - Fax:843-388-1549
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist