Provider Demographics
NPI:1710757653
Name:FISHER, JOHN COVINGTON (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:COVINGTON
Last Name:FISHER
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 1:8 HARBISON WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3402
Mailing Address - Country:US
Mailing Address - Phone:803-261-3260
Mailing Address - Fax:803-454-2294
Practice Address - Street 1:8 HARBISON WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3402
Practice Address - Country:US
Practice Address - Phone:803-261-3260
Practice Address - Fax:803-454-2294
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8781183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist