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General NPI Number Information
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NPI Number | 1538558390
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Entity Type | Organization
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Legal Business Name | CHARLESTON RX LLC
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 2498 N PLEASANTBURG DR SUITE A
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City | GREENVILLE
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State | SC
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Zip | 29609-2730
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Country | US
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Telephone | 864-236-4350
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Fax | 864-236-4360
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Provider Business Mailing Address
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Address Line | 2498 N PLEASANTBURG DR SUITE A
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City | GREENVILLE
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State | SC
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Zip | 29609-2730
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Country | US
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Telephone | 843-212-2967
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Fax | 864-752-2253
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MICHAEL CALNAN
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Credential |
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Telephone | 864-212-2967
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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 | 15922
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License Number State | SC
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