Provider Demographics
NPI:1760820468
Name:FERRILLO, ANDREW M (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:FERRILLO
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 1:4400 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-6849
Mailing Address - Country:US
Mailing Address - Phone:843-554-6193
Mailing Address - Fax:843-554-3594
Practice Address - Street 1:4400 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-6849
Practice Address - Country:US
Practice Address - Phone:843-554-6193
Practice Address - Fax:843-554-3594
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist