Basic Information
| Provider Information | |||||||||
| NPI: | 1952501504 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEBRUHL | ||||||||
| FirstName: | CHRISTIE | ||||||||
| MiddleName: | COGGINS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD, CGP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 GOLDEN SPUR LN | ||||||||
| Address2: | |||||||||
| City: | BLYTHEWOOD | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290167600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033610555 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6439 GARNERS FERRY RD | ||||||||
| Address2: | PHARMACY - 119 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292091638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037764000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2007 | ||||||||
| LastUpdateDate: | 05/25/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 011759 | SC | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.