MEDICARE: DILLON COMMUNITY PHARMACY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1386066132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DILLON COMMUNITY PHARMACY, INC.

Provider Business Mailing Address
First Line	:	200 W HARRISON ST STE A
Second Line	:
City	:	DILLON
State	:	SC
Zip	:	29536-3331
Country	:	US
Telephone Number	:	843-774-4749
Fax Number	:	843-627-0077

Provider Business Practice Location Address
First Line	:	200 W HARRISON ST STE A
Second Line	:
City	:	DILLON
State	:	SC
Zip	:	29536-3331
Country	:	US
Telephone Number	:	843-774-4749
Fax Number	:	843-627-0077

Authorized Official
Title or Position	:	PHARMACIST
Name	:	WILLIAM DUNLAP
Credential	:	RPH
Telephone Number	:	803-984-1560

Provider Enumeration Date	:	01/14/2014
Last Update Date	:	07/11/2014

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