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NPI Code Detail

MEDICARE: COMMUNITY PHARMACY OF CHESTER LLC

MEDICARE: COMMUNITY PHARMACY OF CHESTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy6574SC
43336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12090205OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033118757
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY PHARMACY OF CHESTER LLC
Provider Business Mailing Address
First Line : PO BOX 578
Second Line :
City : CHESTER
State : SC
Zip : 29706-0578
Country : US
Telephone Number : 803-581-2102
Fax Number : 803-581-2121
Provider Business Practice Location Address
First Line : 121 CHURCH ST
Second Line :
City : CHESTER
State : SC
Zip : 29706-2903
Country : US
Telephone Number : 803-581-2102
Fax Number : 803-581-2121
Authorized Official
Title or Position : VICE PRESIDENT
Name : JAMES MARK RICHARDS
Credential :
Telephone Number : 704-904-3287
Provider Enumeration Date : 07/15/2005
Last Update Date : 06/16/2018

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Directions to “COMMUNITY PHARMACY OF CHESTER LLC ” Practice Location

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