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General NPI Number Information
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NPI Number | 1033118757
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Entity Type | Organization
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Legal Business Name | COMMUNITY PHARMACY OF CHESTER LLC
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 121 CHURCH ST
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City | CHESTER
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State | SC
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Zip | 29706-2903
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Country | US
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Telephone | 803-581-2102
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Fax | 803-581-2121
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Provider Business Mailing Address
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Address Line | PO BOX 578
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City | CHESTER
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State | SC
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Zip | 29706-0578
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Country | US
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Telephone | 803-581-2102
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Fax | 803-581-2121
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JAMES MARK RICHARDS
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Credential |
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Telephone | 704-904-3287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 6574
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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