Provider Demographics
NPI:1881115434
Name:WARRICK, DOUGLAS RANDOLPH III (PHARMD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:RANDOLPH
Last Name:WARRICK
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:TRIPP
Other - Middle Name:
Other - Last Name:WARRICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1049 KEY RD UNIT 9
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5455
Mailing Address - Country:US
Mailing Address - Phone:803-507-2153
Mailing Address - Fax:
Practice Address - Street 1:423 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2637
Practice Address - Country:US
Practice Address - Phone:803-957-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist