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Organization
COMMUNITY PHARMACY OF CHESTER LLC
Active
Organization
COMMUNITY PHARMACY OF CHESTER LLC
Active
Other names
BLACKS DRUG STORE INC, Blacks Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MARK RICHARDS (VICE PRESIDENT)
(704) 904-3287
Entity
Organization
Contact information
Practice address
121 CHURCH ST, CHESTER, SC 29706-2903
(803) 581-2102
(803) 581-2121
Mailing address
PO BOX 578, CHESTER, SC 29706-0578
(803) 581-2102
(803) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
6574
SC
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2090205
PK
—
05
—
718772
—
SC
Enumeration date
07/15/2005
Last updated
06/16/2018
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