# MED CENTER PHARMACY & MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MED CENTER LTC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578506853
- **Authorized official:** JUDY DENNIS RPH (PHARMACY MGR)
- **Authorized official phone:** (843) 398-7015

## Contact information

- **Practice address:** 209 RUSSELL ST, SUITE C, DARLINGTON, SC 29532-3311
- **Practice address phone:** (843) 398-7015
- **Practice address fax:** (843) 398-2017
- **Mailing address:** 209 RUSSELL ST, SUITE C, DARLINGTON, SC 29532-3311
- **Mailing address phone:** (843) 398-7015
- **Mailing address fax:** (843) 398-2017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 8620 | SC | Yes |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 04/19/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2092976 | PK | — |
| 05 | — | 785920 | — | SC |