Mary Edith Allen

Individual provider Active NPI Pharmacist · Woodruff, SC

NPI 1720159569 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1720159569
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
005709 (SC)
Practice address
345 S Main St
Woodruff, SC 29388-1867
Phone
(864) 476-2111
Fax
(864) 476-6012
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005709SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Patton Pharmacy Past Accepting new patients
Patton Pharmacy, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 005709 SC Yes

Addresses

Primary practice location

345 S Main St
Woodruff, SC 29388-1867

Mailing address

1150 Southern Comfort Dr
Woodruff, SC 29388-8102
Phone (864) 486-8069

Other providers in Woodruff, SC

All providers in Woodruff, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.