Provider Demographics
NPI:1770030983
Name:MCNEILL, STARCIA RENEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:STARCIA
Middle Name:RENEE
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:STARCIA
Other - Middle Name:RENEE
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301D N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1506 E MONTAGUE AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-5301
Practice Address - Country:US
Practice Address - Phone:843-554-8867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPH36568183500000X
MAPH233831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist