Provider Demographics
NPI:1902381197
Name:LEWIS, DANIEL HARRISON II (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:HARRISON
Last Name:LEWIS
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4326 HOPE PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-4102
Mailing Address - Country:US
Mailing Address - Phone:224-828-8340
Mailing Address - Fax:
Practice Address - Street 1:3951 W ASHLEY CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-9156
Practice Address - Country:US
Practice Address - Phone:843-763-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-038721183500000X
MO2009000321183500000X
TN4833183500000X
ARPD-10892183500000X
SC5533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2009000321OtherPHARMACIST LICENSE
IL051-038721OtherPHARMACIST LICENSE
ARPD-10892OtherPHARMACIST LICENSE
TN4833OtherPHARMACIST LICENSE
SC5533OtherPHARMACIST LICENSE