# CAROLINA HEALTH PHARMACY LLC

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

## Provider details

- **NPI number:** 1205352374
- **Authorized official:** SAMEH IBRAHIM (OWNER)
- **Authorized official phone:** (843) 215-8200

## Contact information

- **Practice address:** 4036 RIVER OAKS DR UNIT B-1, MYRTLE BEACH, SC 29579-6695
- **Practice address phone:** (843) 236-6500
- **Practice address fax:** (843) 584-8534
- **Mailing address:** 4036 RIVER OAKS DR UNIT B-1, MYRTLE BEACH, SC 29579-6695
- **Mailing address phone:** (843) 236-6500
- **Mailing address fax:** (843) 584-8534

## Taxonomy

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

## Other

- **Enumeration date:** 08/20/2017
- **Last updated:** 04/24/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 717565 | — | SC |