Provider Demographics
NPI:1710235353
Name:FALATOK, ANGELA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:FALATOK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1422
Mailing Address - Country:US
Mailing Address - Phone:843-720-8523
Mailing Address - Fax:843-727-7654
Practice Address - Street 1:59 GEORGE ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1422
Practice Address - Country:US
Practice Address - Phone:843-720-8523
Practice Address - Fax:843-727-7654
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist