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General NPI Number Information
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NPI Number | 1316339906
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Entity Type | Organization
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Legal Business Name | SENECA PHARMACY
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Dates
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Enumeration Date | 02/19/2015
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Last Update Date | 07/20/2015
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Provider Practice Location Address
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Address Line | 15891 WELLS HWY
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City | SENECA
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State | SC
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Zip | 29678-1078
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Country | US
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Telephone | 864-985-1359
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Fax | 864-985-1362
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Provider Business Mailing Address
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Address Line | 15891 WELLS HWY
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City | SENECA
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State | SC
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Zip | 29678-1078
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Country | US
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Telephone | 864-985-1359
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Fax | 864-985-1362
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. DONALD L CALVERT
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Credential | RPH
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Telephone | 864-985-1359
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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 | 15645
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License Number State | SC
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