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General NPI Number Information
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NPI Number | 1780732925
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Entity Type | Organization
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Legal Business Name | RIVERWALK PHARMACY INC.
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 149 RIVERWALK BLVD SUITE 10
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City | RIDGELAND
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State | SC
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Zip | 29936-8190
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Country | US
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Telephone | 843-645-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 149 RIVERWALK BLVD SUITE 10
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City | RIDGELAND
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State | SC
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Zip | 29936-8190
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Country | US
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Telephone | 843-645-2600
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Fax |
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | MR. PAUL WILLIAM BRIGHT JR.
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Credential |
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Telephone | 843-645-2600
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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 | 50009125
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License Number State | SC
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