MEDICARE: LAURENS DRUG COMPANY, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1770893349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURENS DRUG COMPANY, LLC

Provider Business Mailing Address
First Line	:	923 W MAIN ST
Second Line	:
City	:	LAURENS
State	:	SC
Zip	:	29360-2605
Country	:	US
Telephone Number	:	864-681-4663
Fax Number	:	864-611-3654

Provider Business Practice Location Address
First Line	:	923 W MAIN ST
Second Line	:
City	:	LAURENS
State	:	SC
Zip	:	29360-2605
Country	:	US
Telephone Number	:	864-681-4663
Fax Number	:	864-611-3654

Authorized Official
Title or Position	:	MEMBER
Name	:	DEAN B YOUMANS
Credential	:
Telephone Number	:	864-681-4663

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	12/20/2010

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