Provider Demographics
NPI:1770712184
Name:LAWSON, TALMADGE (RPH)
Entity type:Individual
Prefix:MR
First Name:TALMADGE
Middle Name:
Last Name:LAWSON
Suffix:
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 1:4500 HARD SCRABBLE ROAD
Mailing Address - Street 2:APARTMENT 418
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9471
Mailing Address - Country:US
Mailing Address - Phone:706-473-2687
Mailing Address - Fax:803-497-3992
Practice Address - Street 1:4500 HARD SCRABBLE ROAD
Practice Address - Street 2:APARTMENT 418
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9471
Practice Address - Country:US
Practice Address - Phone:706-473-2687
Practice Address - Fax:803-497-3992
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC005838183500000X
GARPH016407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist