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Organization
COSTCO
Active
Organization
COSTCO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK MAINS (PHARMACY MANAGER)
(864) 297-2569
Entity
Organization
Contact information
Practice address
1021 WOODRUFF RD, GREENVILLE, SC 29607-4108
(864) 297-2569
Mailing address
1021 WOODRUFF RD, GREENVILLE, SC 29607-4108
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
14212
SC
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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