Healthcare Provider Details

I. General information

NPI: 1336217132
Provider Name (Legal Business Name): GEORGE PARKS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 GEORGIA AVE
NORTH AUGUSTA SC
29841
US

IV. Provider business mailing address

437 GEORGIA AVE
NORTH AUGUSTA SC
29841-3851
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-7450
  • Fax: 803-278-3018
Mailing address:
  • Phone: 803-279-7450
  • Fax: 803-278-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2029
License Number StateSC

VIII. Authorized Official

Name: LAURA KNOTTS
Title or Position: AUTHORIZED USER
Credential:
Phone: 803-279-7450