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General NPI Number Information
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NPI Number | 1538199260
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Entity Type | Organization
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Legal Business Name | COMMUNITY DRUG STORE, INC.
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2956 NEW EASLEY HWY
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City | GREENVILLE
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State | SC
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Zip | 29611-7132
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Country | US
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Telephone | 864-295-0550
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Fax | 864-269-2358
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Provider Business Mailing Address
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Address Line | 2956 NEW EASLEY HWY
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City | GREENVILLE
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State | SC
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Zip | 29611-7132
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Country | US
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Telephone | 864-295-0550
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Fax | 864-269-2358
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. VALEEN S. GOODREAU
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Credential |
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Telephone | 864-295-0550
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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 | 005837
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License Number State | SC
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