Provider Demographics
NPI:1366790388
Name:COLEMAN, CANDICE ELIZABETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:ELIZABETH
Last Name:COLEMAN
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 1:321 KILLIAN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-9607
Mailing Address - Country:US
Mailing Address - Phone:803-754-9999
Mailing Address - Fax:803-754-6005
Practice Address - Street 1:321 KILLIAN RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-9607
Practice Address - Country:US
Practice Address - Phone:803-754-9999
Practice Address - Fax:803-754-6005
Is Sole Proprietor?:No
Enumeration Date:2012-08-23
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist