Provider Demographics
NPI:1366740326
Name:MEYERINK, EDWARD LEONARD III
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:LEONARD
Last Name:MEYERINK
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 OKATIE CENTER BLVD SOUTH
Mailing Address - Street 2:(WALGREENS)
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909
Mailing Address - Country:US
Mailing Address - Phone:843-705-0999
Mailing Address - Fax:843-705-6642
Practice Address - Street 1:138 OKATIE CENTER BLVD SOUTH
Practice Address - Street 2:(WALGREENS)
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909
Practice Address - Country:US
Practice Address - Phone:843-705-0999
Practice Address - Fax:843-705-6642
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist