# COMMUNITY PHARMACY OF CHESTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BLACKS DRUG STORE INC, Blacks Drug Store
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033118757
- **Authorized official:** JAMES MARK RICHARDS (VICE PRESIDENT)
- **Authorized official phone:** (704) 904-3287

## Contact information

- **Practice address:** 121 CHURCH ST, CHESTER, SC 29706-2903
- **Practice address phone:** (803) 581-2102
- **Practice address fax:** (803) 581-2121
- **Mailing address:** PO BOX 578, CHESTER, SC 29706-0578
- **Mailing address phone:** (803) 581-2102
- **Mailing address fax:** (803) 581-2121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 6574 | SC | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/15/2005
- **Last updated:** 06/16/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2090205 | PK | — |
| 05 | — | 718772 | — | SC |