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General NPI Number Information
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NPI Number | 1033641121
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Entity Type | Organization
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Legal Business Name | BANKS DRUG LTC LLC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 632 E MAIN ST
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City | RIDGE SPRING
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State | SC
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Zip | 29129-9139
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Country | US
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Telephone | 803-233-3557
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Fax | 803-250-2623
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Provider Business Mailing Address
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Address Line | PO BOX 308
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City | RIDGE SPRING
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State | SC
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Zip | 29129-0308
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Country | US
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Telephone | 803-233-3557
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Fax | 803-250-2623
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEE BANKS
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Credential |
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Telephone | 803-685-5326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 17163
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License Number State | SC
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