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General NPI Number Information
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NPI Number | 1821141920
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Entity Type | Organization
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Legal Business Name | MEMORIAL PHARMACY INC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 100A SIMPSON ST
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City | GREENVILLE
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State | SC
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Zip | 29605-4413
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Country | US
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Telephone | 864-295-1113
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Fax | 864-295-4419
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Provider Business Mailing Address
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Address Line | 100A SIMPSON ST
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City | GREENVILLE
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State | SC
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Zip | 29605-4413
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Country | US
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Telephone | 864-295-1113
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Fax | 864-295-4419
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. CARL DAVID HILL JR.
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Credential | BSRPH.
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Telephone | 864-295-1113
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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 | 713187
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License Number State | SC
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