Healthcare Provider Details

I. General information

NPI: 1366456634
Provider Name (Legal Business Name): SOCIETY HILL PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 S MAIN ST
SOCIETY HILL SC
29593
US

IV. Provider business mailing address

PO BOX 356 SOCIETY HILL PHARMACY
SOCIETY HILL SC
29593
US

V. Phone/Fax

Practice location:
  • Phone: 843-378-0200
  • Fax: 843-378-0202
Mailing address:
  • Phone: 843-378-0200
  • Fax: 843-378-0202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50001651
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number50001651
License Number StateSC

VIII. Authorized Official

Name: GORDON M HERNDON
Title or Position: OWNER
Credential: RPH
Phone: 843-378-0200