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General NPI Number Information
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NPI Number | 1962554592
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Entity Type | Organization
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Legal Business Name | SOUTH CAROLINA ERICA, INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1926 N BRYANT BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76903-3744
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Country | US
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Telephone | 325-653-3271
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Fax | 325-653-3272
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Provider Business Mailing Address
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Address Line | 1926 N BRYANT BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76903-3744
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Country | US
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Telephone | 325-653-3271
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Fax | 325-653-3272
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Authorized Official
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Title or Position | DIRECTOR, RX SERVICES
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Name | MRS. LINDA JOYCE ROE
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Credential | RPH
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Telephone | 325-658-6551
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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 | 20356
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License Number State | TX
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