Healthcare Provider Details

I. General information

NPI: 1467582270
Provider Name (Legal Business Name): SUMMERTON DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MAIN STREET
SUMMERTON SC
29148
US

IV. Provider business mailing address

PO BOX 37
SUMMERTON SC
29148-0037
US

V. Phone/Fax

Practice location:
  • Phone: 803-485-8725
  • Fax: 803-485-4306
Mailing address:
  • Phone: 803-485-8725
  • Fax: 803-485-4306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENE PHILLIPS
Title or Position: PHARMACIST
Credential:
Phone: 803-485-8725