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General NPI Number Information
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NPI Number | 1477542694
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Entity Type | Organization
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Legal Business Name | CYPRESS CENTER PHARMACY
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 50 HOSPITAL STREET
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City | MANNING
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State | SC
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Zip | 29102-0550
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Country | US
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Telephone | 803-435-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 50 HOSPITAL STREET
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City | MANNING
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State | SC
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Zip | 29102-0550
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Country | US
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Telephone | 803-435-5224
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | RENAE K. CHADWICK
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Credential | RPH
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Telephone | 803-435-5224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 50005730
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License Number State | SC
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