Healthcare Provider Details

I. General information

NPI: 1669626172
Provider Name (Legal Business Name): PARKER ROAD DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 S MAIN ST
WOODRUFF SC
29388-1831
US

IV. Provider business mailing address

339 S MAIN ST
WOODRUFF SC
29388-1831
US

V. Phone/Fax

Practice location:
  • Phone: 864-476-2126
  • Fax:
Mailing address:
  • Phone: 864-476-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateSC

VIII. Authorized Official

Name: MR. CHARLES ROLFE
Title or Position: OWNER
Credential:
Phone: 864-346-3614