Provider Demographics
NPI:1295057099
Name:STAMPER, ANN J (RPH)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:J
Last Name:STAMPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 JOHNNIE DODDS BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3209
Mailing Address - Country:US
Mailing Address - Phone:843-884-0822
Mailing Address - Fax:843-849-1031
Practice Address - Street 1:1551 JOHNNIE DODDS BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3209
Practice Address - Country:US
Practice Address - Phone:843-884-0822
Practice Address - Fax:843-849-1031
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4661OtherSOUTH CAROLINA BOARD OF PHARMACY