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General NPI Number Information
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NPI Number | 1841527785
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Entity Type | Organization
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Legal Business Name | RIDGELAND DRUG COMPANY INC
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Dates
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Enumeration Date | 11/13/2009
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 149 RIVERWALK BLVD STE 1
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City | RIDGELAND
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State | SC
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Zip | 29936-8191
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Country | US
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Telephone | 843-645-0800
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Fax | 843-645-0801
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Provider Business Mailing Address
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Address Line | 149 RIVERWALK BLVD SUITE 18, BOX 191
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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 | 843-645-0800
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Fax | 843-645-0801
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAIGE COUPER
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Credential |
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Telephone | 843-645-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PY 10704
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License Number State | SC
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