Park Pharmacy, Inc
Organization Active NPI Pharmacist · Ware Shoals, SC
NPI 1679679138 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1679679138
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- 3544 (SC)
- 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
- Sep 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Marvin Ray Crawford, RPH
- Title
- Owner/Pharmacist
- Phone
- (864) 456-7411
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Park Pharmacy Inc
Locations
9 E Main St
Ware Shoals, SC 29692
Phone (864) 456-7411
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 3544 | SC | Yes |
Addresses
Primary practice location
9 E Main St
Ware Shoals, SC 29692-1301
Mailing address
PO Box 89
Ware Shoals, SC 29692-0089
Phone (864) 456-7411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 715701 | Medicaid | SC |
Other providers in Ware Shoals, SC
- Pamela J Knight
- KP and Rd LLC
- Jessica Lynn Maffett
- Kimberly R McClain
- Park Pharmacy, Inc
- Joseph Seth Pulley
- Alison M Richter
- Self Medical Group
- Self Regional Healthcare
- Self Regional Healthcare
All providers in Ware Shoals, SC · Pharmacist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.