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Organization
MEDICAL CENTER INC. OF PICKENS
Active
Organization
MEDICAL CENTER INC. OF PICKENS
Active
Other names
CUSTOM-MED COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN E. HOLLAND PHARM D (PRESIDENT)
(864) 855-2323
Entity
Organization
Contact information
Practice address
838 POWDERSVILLE RD, SUITE D, EASLEY, SC 29642-3703
(864) 855-2323
(864) 855-2606
Mailing address
838 POWDERSVILLE RD, SUITE D, EASLEY, SC 29642-3703
(864) 855-2323
(864) 855-2606
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
608612
—
SC
05
—
708614
—
SC
Enumeration date
05/16/2006
Last updated
08/22/2020
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