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General NPI Number Information
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NPI Number | 1578506853
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Entity Type | Organization
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Legal Business Name | MED CENTER PHARMACY & MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 209 RUSSELL ST SUITE C
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City | DARLINGTON
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State | SC
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Zip | 29532-3311
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Country | US
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Telephone | 843-398-7015
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Fax | 843-398-2017
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Provider Business Mailing Address
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Address Line | 209 RUSSELL ST SUITE C
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City | DARLINGTON
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State | SC
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Zip | 29532-3311
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Country | US
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Telephone | 843-398-7015
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Fax | 843-398-2017
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Authorized Official
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Title or Position | PHARMACY MGR
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Name | JUDY DENNIS
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Credential | RPH
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Telephone | 843-398-7015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 8620
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License Number State | SC
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