Park Pharmacy, Inc

Organization Active NPI Durable Medical Equipment & Medical Supplies · Ware Shoals, SC

NPI 1104022516 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1104022516
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
PARK PHARMACY, INC
Practice address
9 E Main St
Ware Shoals, SC 29692-1301
Phone
(864) 456-7411
Fax
(864) 456-3026
NPI assigned
Jun 22, 2007
Organization subpart
No

Authorized official

Name
Marvin R Crawford, RPH
Title
Owner
Phone
(864) 456-7411

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Park Pharmacy Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

9 E Main St
Ware Shoals, SC 29692-1301

Mailing address

9 E Main St
Ware Shoals, SC 29692-1301
Phone (864) 456-7411

Other identifiers

IdentifierTypeStateIssuer
715701MedicaidSC

Other providers in Ware Shoals, SC

All providers in Ware Shoals, SC · Durable Medical Equipment & Medical Supplies in South Carolina

Sources for this page

Verify at the official NPI Registry.