Provider Demographics
NPI:1851710503
Name:GINN, AMY (BS PHARMACY)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:GINN
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 N HIGHWAY 52
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-3132
Mailing Address - Country:US
Mailing Address - Phone:843-899-5755
Mailing Address - Fax:843-899-5760
Practice Address - Street 1:511 N HIGHWAY 52
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3132
Practice Address - Country:US
Practice Address - Phone:843-899-5755
Practice Address - Fax:843-899-5760
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist