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Organization
OCEAN LAKES PHARMACY INC
Active
Organization
OCEAN LAKES PHARMACY INC
Active
Other names
OCEAN LAKES PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WILLIAMS (OWNER)
(848) 238-5159
Entity
Organization
Contact information
Practice address
1415 HWY 17 BUSINESS N, SURFSIDE BEACH, SC 29575
(843) 238-5159
(843) 238-8270
Mailing address
1415 HWY 17 BUSINESS N, SURFSIDE BEACH, SC 29575
(843) 238-5159
(843) 238-8270
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
50004721
SC
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2088907
PK
—
05
—
611804
—
SC
05
—
747216
—
SC
05
—
EN2106
—
SC
Enumeration date
10/23/2006
Last updated
02/28/2017
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