Healthcare Provider Details

I. General information

NPI: 1659351427
Provider Name (Legal Business Name): MILL STREET DRUGS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 S MILL ST
MANNING SC
29102-2918
US

IV. Provider business mailing address

419 S MILL ST
MANNING SC
29102-2918
US

V. Phone/Fax

Practice location:
  • Phone: 803-433-2212
  • Fax: 803-433-2656
Mailing address:
  • Phone: 803-433-2212
  • Fax: 803-433-2656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number50008944
License Number StateSC

VIII. Authorized Official

Name: DR. ELIZABETH PATRICK DURANT
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 803-433-2212