Provider Demographics
NPI:1942468491
Name:TODD, CRYSTAL FAITH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:FAITH
Last Name:TODD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 KNOX ABBOTT DR
Mailing Address - Street 2:
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-4126
Mailing Address - Country:US
Mailing Address - Phone:803-454-0194
Mailing Address - Fax:803-451-7129
Practice Address - Street 1:615 KNOX ABBOTT DR
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-4126
Practice Address - Country:US
Practice Address - Phone:803-454-0194
Practice Address - Fax:803-451-7129
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0010974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist