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General NPI Number Information
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NPI Number | 1891770574
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Entity Type | Organization
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Legal Business Name | SUMMERTON DRUGS INC
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 115 E MAIN ST
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City | SUMMERTON
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State | SC
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Zip | 29148-6904
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Country | US
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Telephone | 803-485-8725
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Fax | 803-485-4306
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Provider Business Mailing Address
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Address Line | PO BOX 37
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City | SUMMERTON
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State | SC
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Zip | 29148-0037
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Country | US
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Telephone | 803-485-8725
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Fax | 803-485-4306
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Authorized Official
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Title or Position | OWNER,AO
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Name | EUGENE PHILLIPS
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Credential |
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Telephone | 803-485-8725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 8933
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License Number State | SC
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