Provider Demographics
NPI:1861658023
Name:HONEYCUTT, LISA FITZGERALD (RPH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:FITZGERALD
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 CROSSROADS PLZ
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8017
Mailing Address - Country:US
Mailing Address - Phone:803-547-6100
Mailing Address - Fax:803-547-7720
Practice Address - Street 1:729 CROSSROADS PLZ
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8017
Practice Address - Country:US
Practice Address - Phone:803-547-6100
Practice Address - Fax:803-547-7720
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist