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General NPI Number Information
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NPI Number | 1699967794
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Entity Type | Organization
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Legal Business Name | CAROLINA HEALTH CARE RETAIL PHARMACY
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 506 EAST CHEVES STREET
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City | FLORENCE
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State | SC
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Zip | 29506
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Country | US
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Telephone | 843-413-4130
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Fax | 843-413-4131
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Provider Business Mailing Address
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Address Line | 506 EAST CHEVES STREET
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City | FLORENCE
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State | SC
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Zip | 29506
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Country | US
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Telephone | 843-413-4130
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Fax | 843-413-4131
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAJESH BAJAJ
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Credential | MD
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Telephone | 843-413-3152
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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 | 50009549
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License Number State | SC
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