Provider Demographics
NPI:1871890954
Name:LEWIS, DEANA (PHARMD)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:LEWIS
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 1:1100 S KILBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-4852
Mailing Address - Country:US
Mailing Address - Phone:803-331-6580
Mailing Address - Fax:
Practice Address - Street 1:8910 OLD NUMBER SIX HWY
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:SC
Practice Address - Zip Code:29142-8607
Practice Address - Country:US
Practice Address - Phone:803-787-2527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist