Healthcare Provider Details

I. General information

NPI: 1609651520
Provider Name (Legal Business Name): MORNING STAR PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

572 PINE LOG RD
BEECH ISLAND SC
29842-7643
US

IV. Provider business mailing address

PO BOX 7693
NORTH AUGUSTA SC
29861-7693
US

V. Phone/Fax

Practice location:
  • Phone: 803-830-6337
  • Fax:
Mailing address:
  • Phone: 803-830-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA K BROWN
Title or Position: OWNER/PARTNER
Credential: PHARMD
Phone: 912-695-0414