Provider Demographics
NPI:1750118188
Name:DEL TORO, ETHAN (PHARMD)
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:
Last Name:DEL TORO
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 1:112 NICKLE PLATE RD
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-4414
Mailing Address - Country:US
Mailing Address - Phone:843-208-3605
Mailing Address - Fax:
Practice Address - Street 1:112 NICKLE PLATE RD
Practice Address - Street 2:
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-4414
Practice Address - Country:US
Practice Address - Phone:843-208-3605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPH60380183500000X
GARPH035295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist