Provider Demographics
NPI:1730802414
Name:REVIS, MORGAN MORRIS (PHARMD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MORRIS
Last Name:REVIS
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 1:599 RICE AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-1840
Mailing Address - Country:US
Mailing Address - Phone:864-427-7668
Mailing Address - Fax:
Practice Address - Street 1:599 RICE AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-1840
Practice Address - Country:US
Practice Address - Phone:864-427-7668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist