Healthcare Provider Details

I. General information

NPI: 1538660931
Provider Name (Legal Business Name): PC COMMUNITY CARE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 N BROAD ST
CLINTON SC
29325-2305
US

IV. Provider business mailing address

307 N BROAD ST
CLINTON SC
29325-2305
US

V. Phone/Fax

Practice location:
  • Phone: 864-938-3932
  • Fax: 888-972-4548
Mailing address:
  • Phone: 864-938-3932
  • Fax: 888-972-4548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NANCY A TAYLOR
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMACIST
Phone: 803-518-4240