Provider Demographics
NPI:1780840652
Name:MORGA, MAGDALENO COLUMNA
Entity Type:Individual
Prefix:MR
First Name:MAGDALENO
Middle Name:COLUMNA
Last Name:MORGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 RIVERS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7072
Mailing Address - Country:US
Mailing Address - Phone:843-745-4124
Mailing Address - Fax:
Practice Address - Street 1:3725 RIVERS AVE STE 2
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7072
Practice Address - Country:US
Practice Address - Phone:843-745-4124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC004672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist