Kendra Martin
Individual provider Active NPI Pharmacist · Tega Cay, SC
NPI 1104246651 · NPPES record last updated Apr 23, 2014
Key facts
- NPI
- 1104246651
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 9398 (SC)
- Practice address
- 1151 Stonecrest Blvd
Tega Cay, SC 29708-6555 - Phone
- (803) 578-4120
- Fax
- (803) 578-4123
- NPI assigned
- Apr 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9398 | SC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9398 | SC | Yes |
Addresses
Primary practice location
1151 Stonecrest Blvd
Tega Cay, SC 29708-6555
Mailing address
1151 Stonecrest Blvd
Tega Cay, SC 29708-6555
Phone (803) 578-4120
Other providers in Tega Cay, SC
- Cynthia Leone
- Cherilyn Livingston
- Genna Lauren Long
- Jodie Roberta Lowry
- Maria Wilson, PT, LLC
- Paul G Martino
- Ann Marie May
- Jessica McCorkle
- Hannah McLaurin Melton
- Barbara Allison Moore
All providers in Tega Cay, SC · Pharmacist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.