Healthcare Provider Details

I. General information

NPI: 1841280625
Provider Name (Legal Business Name): KEMPSON REXALL DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 N MAIN ST
INMAN SC
29349-1425
US

IV. Provider business mailing address

27 N MAIN ST
INMAN SC
29349-1425
US

V. Phone/Fax

Practice location:
  • Phone: 864-472-2136
  • Fax: 864-472-2136
Mailing address:
  • Phone: 864-472-2136
  • Fax: 864-472-2136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2209
License Number StateSC

VIII. Authorized Official

Name: MARIANNE SMITH
Title or Position: PHARMACIST/VICE PRESIDENT
Credential:
Phone: 864-472-2136