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General NPI Number Information
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NPI Number | 1306953096
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Entity Type | Organization
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Legal Business Name | F & L DRUG STORE INC
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 223 N JONES RD
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City | OLANTA
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State | SC
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Zip | 29114-0428
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Country | US
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Telephone | 843-396-4431
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Fax | 843-396-4658
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | OLANTA
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State | SC
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Zip | 29114-0428
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Country | US
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Telephone | 843-396-4431
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Fax | 843-396-4658
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MONICA MICHELLE VARGAS
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Credential | R. PH.
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Telephone | 843-396-4431
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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 | 50004377
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License Number State | SC
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