Healthcare Provider Details

I. General information

NPI: 1770994956
Provider Name (Legal Business Name): APOTHECORP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2014
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1393 CELANESE RD
ROCK HILL SC
29732-1722
US

IV. Provider business mailing address

223 E MAIN ST STE 601
ROCK HILL SC
29730-4571
US

V. Phone/Fax

Practice location:
  • Phone: 803-326-3380
  • Fax: 888-715-1798
Mailing address:
  • Phone: 803-470-1041
  • Fax: 888-715-1798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number15545
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROSALIND CHORAK
Title or Position: PHARMACIST IN CHARGE
Credential: B.S. PHARMACY
Phone: 803-326-3380