MEDICARE: GOOD 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	183500000X	Pharmacist	50000311	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750444311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD PHARMACY INC.

Provider Business Mailing Address
First Line	:	1237 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-327-2081
Fax Number	:	803-327-3585

Provider Business Practice Location Address
First Line	:	1237 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-327-2081
Fax Number	:	803-327-3585

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	MRS. LOIS JONES HYATT
Credential	:
Telephone Number	:	803-327-2081

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	08/14/2023

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Directions to “GOOD PHARMACY INC. ” Practice Location

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