Healthcare Provider Details

I. General information

NPI: 1679519128
Provider Name (Legal Business Name): PROCARE RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5119 A CALHOUND MEMORIAL HWY
EASLEY SC
29640
US

IV. Provider business mailing address

PO BOX 559
EASLEY SC
29641-0559
US

V. Phone/Fax

Practice location:
  • Phone: 864-859-0283
  • Fax: 864-859-6162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50005290
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN OBRIEN
Title or Position: OWNER
Credential: RPH
Phone: 864-644-0203