Healthcare Provider Details

I. General information

NPI: 1457436628
Provider Name (Legal Business Name): HEALTH CARE PARTNERS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 MAIN ST
CONWAY SC
29526-3572
US

IV. Provider business mailing address

1608 MAIN ST
CONWAY SC
29526-3572
US

V. Phone/Fax

Practice location:
  • Phone: 843-488-6341
  • Fax:
Mailing address:
  • Phone: 843-488-6341
  • Fax: 843-488-6346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number5861
License Number StateSC

VIII. Authorized Official

Name: SANTINA MAYO
Title or Position: CEO
Credential:
Phone: 843-488-6364