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General NPI Number Information
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NPI Number | 1881615854
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Entity Type | Organization
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Legal Business Name | BUFORD ST DRUG STORE
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 113 W BUFORD ST
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City | GAFFNEY
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State | SC
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Zip | 29340-3001
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Country | US
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Telephone | 864-488-3036
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Fax | 864-488-0316
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Provider Business Mailing Address
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Address Line | 113 W BUFORD ST
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City | GAFFNEY
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State | SC
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Zip | 29340-3001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL BRADFORD BAILEY
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Credential | PHARM D
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Telephone | 864-488-3036
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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 | 50006358
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License Number State | SC
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