Healthcare Provider Details

I. General information

NPI: 1902317605
Provider Name (Legal Business Name): ERIC DILLON DR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9718 N KINGS HWY
MYRTLE BEACH SC
29572-4013
US

IV. Provider business mailing address

709 APPLEBY WAY APT 7G
MYRTLE BEACH SC
29572-2324
US

V. Phone/Fax

Practice location:
  • Phone: 843-497-8625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number42890
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: