Healthcare Provider Details

I. General information

NPI: 1528253945
Provider Name (Legal Business Name): KERR DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8995 UNIVERSITY BLVD
NORTH CHARLESTON SC
29406-9116
US

IV. Provider business mailing address

PO BOX 75678
CHARLOTTE NC
28275-0678
US

V. Phone/Fax

Practice location:
  • Phone: 843-410-0701
  • Fax: 843-410-0714
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number509611
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GRAY STEWART
Title or Position: DIR OF PHCY ADMIN
Credential:
Phone: 919-544-3896