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General NPI Number Information
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NPI Number | 1538217401
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Entity Type | Organization
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Legal Business Name | CHILDREN'S CARE PHARMACY
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 1530 MCCLURE COURT
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City | FLORENCE
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State | SC
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Zip | 29505
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Country | US
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Telephone | 843-679-1881
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Fax | 843-679-1887
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Provider Business Mailing Address
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Address Line | 1530 MCCLURE COURT
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City | FLORENCE
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State | SC
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Zip | 29505
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Country | US
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Telephone | 843-679-1881
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Fax | 843-679-1887
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Authorized Official
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Title or Position | PHARMACIST, CEO
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Name | MR. TERRY T LEWIS
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Credential | RPH
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Telephone | 843-679-1881
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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 | 50008779
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | DE2870
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License Number State | SC
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