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General NPI Number Information
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NPI Number | 1831060078
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Entity Type | Organization
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Legal Business Name | MBD PHARMACY
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 6507 N KINGS HWY
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-3010
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Country | US
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Telephone | 843-692-9494
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Fax | 843-692-7474
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Provider Business Mailing Address
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Address Line | 6507 N KINGS HWY
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-3010
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Country | US
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Telephone | 843-692-9494
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Fax | 843-692-7474
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Authorized Official
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Title or Position | PHARMACIST
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Name | LAURA GORE
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Credential | RPH
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Telephone | 843-692-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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