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General NPI Number Information
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NPI Number | 1114251337
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Entity Type | Organization
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Legal Business Name | HAWTHORNE LUGOFF PHARMACY, LLC
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 710 HIGHWAY 1 S
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City | LUGOFF
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State | SC
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Zip | 29078
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Country | US
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Telephone | 803-408-9589
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Fax | 803-408-9854
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Provider Business Mailing Address
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Address Line | PO BOX 638
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City | LUGOFF
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State | SC
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Zip | 29078-0638
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Country | US
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Telephone | 803-408-9589
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Fax | 803-408-9854
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MRS. KRISTIE CASSIDY
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Credential | R.PH.
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Telephone | 803-227-4464
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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 | PENDING
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License Number State | SC
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