# BANKS PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114108735
- **Authorized official:** MR. KEITH JAMES MATTHEWS R.PH. (PHARMACIST-IN-CHARGE)
- **Authorized official phone:** (706) 869-9799

## Contact information

- **Practice address:** 100 RIDGE MEDICAL PLAZA, SUITE 101, EDGEFIELD, SC 29824
- **Practice address phone:** (803) 637-5757
- **Practice address fax:** (803) 637-9996
- **Mailing address:** 100 RIDGE MEDICAL PLAZA, SUITE 101, EDGEFIELD, SC 29824
- **Mailing address phone:** (803) 637-5757
- **Mailing address fax:** (803) 637-9996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 11/26/2007
- **Last updated:** 05/02/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 797882 | — | SC |