Healthcare Provider Details

I. General information

NPI: 1295857456
Provider Name (Legal Business Name): HANNAS DISCOUNT PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 EAST RAILROAD AVE
ESTILL SC
29918-1088
US

IV. Provider business mailing address

PO BOX 1088 BOX 1088
ESTILL SC
29918-1088
US

V. Phone/Fax

Practice location:
  • Phone: 803-625-4185
  • Fax: 803-625-2443
Mailing address:
  • Phone: 803-625-4185
  • Fax: 803-625-2443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberDME725
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberDME725
License Number StateSC

VIII. Authorized Official

Name: CHRIS MICHAEL HANNA SR.
Title or Position: RPH OWNER
Credential: BS RPH
Phone: 803-625-4185