=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679571996
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FORDS DRUGS AND MEDICAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2005
-----------------------------------------------------
Last Update Date | 12/31/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 435 E MAIN ST SUITE2
-----------------------------------------------------
City | SPARTANBURG
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29302-1981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-585-3325
-----------------------------------------------------
Fax | 864-583-6497
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 435 E MAIN ST SUITE2
-----------------------------------------------------
City | SPARTANBURG
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29302-1981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-585-3325
-----------------------------------------------------
Fax | 864-583-6497
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KATHERINE CASH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 864-585-3341
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | SC3104
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------