Provider Demographics
NPI:1801434477
Name:VANDERHORST, JAMEAL INEZ (PHARM-D)
Entity type:Individual
Prefix:DR
First Name:JAMEAL
Middle Name:INEZ
Last Name:VANDERHORST
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:PO BOX 714
Mailing Address - Street 2:
Mailing Address - City:MC CLELLANVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29458-0714
Mailing Address - Country:US
Mailing Address - Phone:843-813-5859
Mailing Address - Fax:
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6417
Practice Address - Country:US
Practice Address - Phone:843-871-0310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist