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General NPI Number Information
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NPI Number | 1215007398
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Entity Type | Organization
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Legal Business Name | PEE DEE FAMILY PHARMACY
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 608 N 4TH AVE
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City | DILLON
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State | SC
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Zip | 29536-2502
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Country | US
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Telephone | 843-841-9003
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Fax | 843-841-9736
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Provider Business Mailing Address
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Address Line | 608 N 4TH AVE
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City | DILLON
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State | SC
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Zip | 29536-2502
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Country | US
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Telephone | 843-841-9003
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Fax | 843-841-9736
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Authorized Official
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Title or Position | OWNER
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Name | CARL ALTMAR
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Credential | PHARM D
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Telephone | 843-841-9003
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 10377
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License Number State | SC
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