Healthcare Provider Details

I. General information

NPI: 1982933263
Provider Name (Legal Business Name): COMMUNITY MEDICINE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SALUDA ST
CHESTER SC
29706-1580
US

IV. Provider business mailing address

102 CESTRAIN SQ
CHESTER SC
29706-1978
US

V. Phone/Fax

Practice location:
  • Phone: 803-581-7209
  • Fax: 803-377-7148
Mailing address:
  • Phone: 803-412-3352
  • Fax: 803-412-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6513
License Number StateSC

VIII. Authorized Official

Name: MR. ERNEST BROWN
Title or Position: CEO
Credential:
Phone: 803-412-3352