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General NPI Number Information
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NPI Number | 1841237245
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Entity Type | Organization
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Legal Business Name | PRUITTHEALTH PHARMACY SERVICES, INC.
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 328 RIVERCHASE WAY
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City | LEXINGTON
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State | SC
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Zip | 29072-8010
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Country | US
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Telephone | 803-739-4949
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Fax | 803-739-4950
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Provider Business Mailing Address
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Address Line | 1626 JEURGENS CT
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City | NORCROSS
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State | GA
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Zip | 30093-2219
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Country | US
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Telephone | 770-279-6200
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN AND CEO
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Name | NEIL L PRUITT JR.
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Credential |
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Telephone | 770-279-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 50006741
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License Number State | SC
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