Healthcare Provider Details

I. General information

NPI: 1437283058
Provider Name (Legal Business Name): SANDHILLS PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 S SEVENTH STREET
MCBEE SC
29101
US

IV. Provider business mailing address

PO BOX 900
MC BEE SC
29101-0900
US

V. Phone/Fax

Practice location:
  • Phone: 843-335-8297
  • Fax: 843-335-8555
Mailing address:
  • Phone: 843-335-8297
  • Fax: 843-335-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50002450
License Number StateSC

VIII. Authorized Official

Name: ROBERT M DEFEE
Title or Position: PRESIDENT
Credential: CDE
Phone: 843-335-8297