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General NPI Number Information
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NPI Number | 1801927017
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Entity Type | Organization
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Legal Business Name | HOLLY STREET DRUGS, LLC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 904 HOLLY ST
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City | HOLLY HILL
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State | SC
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Zip | 29059
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Country | US
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Telephone | 803-496-0007
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Fax | 803-496-0015
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | HOLLY HILL
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State | SC
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Zip | 29059
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Country | US
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Telephone | 803-496-0007
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Fax | 803-496-0015
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Authorized Official
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Title or Position | PLC/OWNER
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Name | RACHEL OSTEEN
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Credential |
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Telephone | 803-496-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 50007564
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | SC
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