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General NPI Number Information
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NPI Number | 1134102460
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Entity Type | Organization
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Legal Business Name | MCLESKEY TODD PHARMACY OF TRAVELERS REST INC
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32 SOUTH MAIN STREET
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City | TRAVELERS REST
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State | SC
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Zip | 29690
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Country | US
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Telephone | 864-834-4678
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Fax | 834-834-4614
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Provider Business Mailing Address
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Address Line | PO BOX 487
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City | TRAVELERS REST
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State | SC
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Zip | 29690-0487
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Country | US
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Telephone | 864-834-4678
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Fax | 864-834-4614
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Authorized Official
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Title or Position | OWNER
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Name | MR. IRVIN STACK HARMON JR.
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Credential | RPH
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Telephone | 864-834-4678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50003094
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License Number State | SC
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