Provider Demographics
NPI:1245651132
Name:MANNING, JAMES HAMPTON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HAMPTON
Last Name:MANNING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 WINDING RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-9436
Mailing Address - Country:US
Mailing Address - Phone:843-845-7905
Mailing Address - Fax:843-215-3690
Practice Address - Street 1:2751 BEAVER RUN BLVD
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-5381
Practice Address - Country:US
Practice Address - Phone:843-231-3174
Practice Address - Fax:843-215-3690
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist