Healthcare Provider Details
I. General information
NPI: 1164628996
Provider Name (Legal Business Name): MORAL OF PICKENS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2007
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 W CEDAR ROCK ST
PICKENS SC
29671-2451
US
IV. Provider business mailing address
PO BOX 66
PICKENS SC
29671-0066
US
V. Phone/Fax
- Phone: 864-878-6357
- Fax: 864-878-6301
- Phone: 864-878-6357
- Fax: 864-878-6301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 50001047 |
| License Number State | SC |
VIII. Authorized Official
Name: DR.
TODD
ALLEN
MORRIS
Title or Position: OWNER, PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 864-878-6357