# MODIFICARE LLC

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

## Provider details

- **NPI number:** 1154365468
- **Authorized official:** DENO SEBASTIAN (OWNER)
- **Authorized official phone:** (757) 763-8588

## Contact information

- **Practice address:** 1023A W DEKALB ST, CAMDEN, SC 29020-4162
- **Practice address phone:** (803) 424-0064
- **Practice address fax:** (803) 425-8173
- **Mailing address:** 1023A W DEKALB ST, CAMDEN, SC 29020-4162
- **Mailing address phone:** (803) 424-0064
- **Mailing address fax:** (803) 425-8173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 6496 | SC | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/16/2006
- **Last updated:** 06/09/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2092185 | PK | — |
| 05 | — | 764962 | — | SC |
| 05 | — | 7Z1235 | — | SC |
| 05 | — | DE2114 | — | SC |