Healthcare Provider Details

I. General information

NPI: 1770563231
Provider Name (Legal Business Name): SUMTER CUT RATE DRUG STORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 S MAIN ST
SUMTER SC
29150-5245
US

IV. Provider business mailing address

32 S MAIN ST
SUMTER SC
29150-5245
US

V. Phone/Fax

Practice location:
  • Phone: 803-773-8432
  • Fax: 803-436-5533
Mailing address:
  • Phone: 803-773-8432
  • Fax: 803-436-5533

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number50005096
License Number StateSC
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROY NORBERT FLYNN
Title or Position: OWNER
Credential:
Phone: 803-968-7000