# MEDICAL CENTER INC. OF PICKENS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CUSTOM-MED COMPOUNDING PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134170764
- **Authorized official:** MR. JOHN E. HOLLAND PHARM D (PRESIDENT)
- **Authorized official phone:** (864) 855-2323

## Contact information

- **Practice address:** 838 POWDERSVILLE RD, SUITE D, EASLEY, SC 29642-3703
- **Practice address phone:** (864) 855-2323
- **Practice address fax:** (864) 855-2606
- **Mailing address:** 838 POWDERSVILLE RD, SUITE D, EASLEY, SC 29642-3703
- **Mailing address phone:** (864) 855-2323
- **Mailing address fax:** (864) 855-2606

## Taxonomy

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

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 608612 | — | SC |
| 05 | — | 708614 | — | SC |