Healthcare Provider Details

I. General information

NPI: 1912016593
Provider Name (Legal Business Name): MOBLEY DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1073 W MEETING ST
LANCASTER SC
29720-2205
US

IV. Provider business mailing address

1073 W MEETING ST
LANCASTER SC
29720-2205
US

V. Phone/Fax

Practice location:
  • Phone: 803-285-5555
  • Fax: 803-285-7990
Mailing address:
  • Phone: 803-285-2021
  • Fax: 803-285-7990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50-001658
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number50-001658
License Number StateSC

VIII. Authorized Official

Name: MR. HUBERT F. MOBLEY
Title or Position: OWNER
Credential: R.PH
Phone: 803-285-2021