Healthcare Provider Details

I. General information

NPI: 1164426938
Provider Name (Legal Business Name): BLOCKER & TIMMERMAN DRUG CO.,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MAIN ST
EDGEFIELD SC
29824-1326
US

IV. Provider business mailing address

300 MAIN ST
EDGEFIELD SC
29824-1326
US

V. Phone/Fax

Practice location:
  • Phone: 803-637-6155
  • Fax: 803-637-3753
Mailing address:
  • Phone: 803-637-6155
  • Fax: 803-637-3753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50-000987
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number50-000987
License Number StateSC

VIII. Authorized Official

Name: MR. JACK B. HODGE
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 803-637-6155