NPI Code Details Logo

NPI 1528079175

NPI 1528079175 : CROMER MEDICAL SERVICES INC : NEWBERRY, SC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1528079175
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CROMER MEDICAL SERVICES INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/10/2006
-----------------------------------------------------
    Last Update Date     |    04/12/2021
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1310 WILSON RD 
-----------------------------------------------------
    City                 |    NEWBERRY
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29108-3048
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    803-276-0990
-----------------------------------------------------
    Fax                  |    803-276-4276
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1310 WILSON RD 
-----------------------------------------------------
    City                 |    NEWBERRY
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29108-3048
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    803-276-0990
-----------------------------------------------------
    Fax                  |    803-276-4276
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PHARMACY MANAGER
-----------------------------------------------------
    Name                 |     CANDACE  FRICK 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    803-276-0990
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    333600000X
-----------------------------------------------------
    Taxonomy Name        |    Pharmacy
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    3336C0003X
-----------------------------------------------------
    Taxonomy Name        |    Community/Retail Pharmacy
-----------------------------------------------------
    License Number       |    5289
-----------------------------------------------------
    License Number State |    SC
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.