Provider Demographics
NPI:1710273594
Name:PRESBYTERIAN COLLEGE
Entity Type:Organization
Organization Name:PRESBYTERIAN COLLEGE
Other - Org Name:SCHOOL OF PHARMACY; PCSP DIABETES CENTER; PCSP WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:STULL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:864-938-3901
Mailing Address - Street 1:307 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-2305
Mailing Address - Country:US
Mailing Address - Phone:864-938-3900
Mailing Address - Fax:
Practice Address - Street 1:307 N BROAD ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-2305
Practice Address - Country:US
Practice Address - Phone:864-938-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESBYTERIAN COLLEGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC111101835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty