Provider Demographics
NPI:1831481779
Name:ROSS, LINDSAY TYLER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:TYLER
Last Name:ROSS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 SAM RITTENBERG BLVD
Mailing Address - Street 2:TARGET PHARMACY 1391
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4605
Mailing Address - Country:US
Mailing Address - Phone:843-766-2130
Mailing Address - Fax:
Practice Address - Street 1:2070 SAM RITTENBERG BLVD
Practice Address - Street 2:TARGET PHARMACY 1391
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4605
Practice Address - Country:US
Practice Address - Phone:843-766-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist