# LONGS DRUGSTORES OF SC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LONGS MEDICAL PARK PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053403964
- **Authorized official:** MARSHALL FROST (DIRECTOR OF BUSINESS DEV)
- **Authorized official phone:** (404) 583-6945

## Contact information

- **Practice address:** 115 BLARNEY DR STE 105, SUITE 105, COLUMBIA, SC 29223-6291
- **Practice address phone:** (803) 788-9608
- **Practice address fax:** (803) 788-7170
- **Mailing address:** PO BOX 602688, CHARLOTTE, NC 28260-2688
- **Mailing address phone:** (803) 788-9608
- **Mailing address fax:** (803) 788-7170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 15059 | SC | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 03/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1053403964 | — | SC |
| 01 | — | 2089902 | PK | — |