Healthcare Provider Details

I. General information

NPI: 1609881200
Provider Name (Legal Business Name): DEPALMA DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 S MAIN ST
ANDERSON SC
29624-1623
US

IV. Provider business mailing address

314 S MAIN ST
ANDERSON SC
29624-1623
US

V. Phone/Fax

Practice location:
  • Phone: 864-226-1201
  • Fax: 864-224-3034
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50001038
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL DEPALMA
Title or Position: PRESIDENT/PHARMACIST
Credential:
Phone: 864-224-6401