Provider Demographics
NPI:1952957615
Name:WHEATLEY, CAROLINE GRACE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:GRACE
Last Name:WHEATLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1011
Mailing Address - Country:US
Mailing Address - Phone:843-521-7575
Mailing Address - Fax:
Practice Address - Street 1:61 LADYS ISLAND DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1618
Practice Address - Country:US
Practice Address - Phone:843-986-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist