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General NPI Number Information
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NPI Number | 1265631485
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Entity Type | Organization
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Legal Business Name | S.C. DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 1736 S MAIN ST
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City | GREENWOOD
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State | SC
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Zip | 29646-4124
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Country | US
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Telephone | 864-227-5950
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Fax | 864-953-6313
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Provider Business Mailing Address
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Address Line | 1751 CALHOUN ST PO BOX 101106
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City | COLUMBIA
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State | SC
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Zip | 29201-2606
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Country | US
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Telephone | 803-898-0813
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Fax | 803-898-0557
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CAROLINE Y SOJOURNER
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Credential | RPH
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Telephone | 803-898-0813
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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 | 50-010575
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License Number State | SC
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