# TIMMONSVILLE DRUG INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TIMMONSVILLE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083675391
- **Authorized official:** DOUGLAS MOORE (TREASURER MANG)
- **Authorized official phone:** (843) 346-5410

## Contact information

- **Practice address:** 309 E SMITH ST, TIMMONSVILLE, SC 29161-1821
- **Practice address phone:** (843) 346-5410
- **Practice address fax:** (843) 346-5414
- **Mailing address:** 309 E SMITH ST, TIMMONSVILLE, SC 29161-1821
- **Mailing address phone:** (843) 346-5410
- **Mailing address fax:** (843) 346-5414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 4683 | SC | Yes |

## Other

- **Enumeration date:** 03/28/2006
- **Last updated:** 08/07/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4216568 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 05 | — | 746837 | — | SC |