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General NPI Number Information
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NPI Number | 1679670517
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Entity Type | Organization
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Legal Business Name | MEDICINE MART OF GAFFNEY
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 305 N LIMESTONE ST
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City | GAFFNEY
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State | SC
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Zip | 29340-3171
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Country | US
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Telephone | 864-489-5198
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Fax | 864-488-9297
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Provider Business Mailing Address
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Address Line | 305 N LIMESTONE ST
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City | GAFFNEY
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State | SC
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Zip | 29340-3171
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Country | US
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Telephone | 864-489-5198
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Fax | 864-488-9297
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Authorized Official
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Title or Position | VP
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Name | ROY FLYNN
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Credential |
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Telephone | 803-968-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 17352
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License Number State | SC
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