# PELHAM ROAD PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PELHAM ROAD PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235140807
- **Authorized official:** SAMIR PATEL RPH (PHARMACIST IN CHARGE)
- **Authorized official phone:** (864) 234-5890

## Contact information

- **Practice address:** 800B PELHAM RD, GREENVILLE, SC 29615-3300
- **Practice address phone:** (864) 234-5890
- **Practice address fax:** (864) 234-5891
- **Mailing address:** 800B PELHAM RD, GREENVILLE, SC 29615-3300
- **Mailing address phone:** (864) 234-5890
- **Mailing address fax:** (864) 234-5891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 2040 | SC | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 05/26/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2089695 | PK | — |
| 05 | — | 720401 | — | SC |