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Organization
ZIVITSKI HEALTH GROUP LLC
Active
Organization
ZIVITSKI HEALTH GROUP LLC
Active
Other names
Gray Court Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD ZIVITSKI (OWNER)
(864) 876-3837
Entity
Organization
Contact information
Practice address
345 W MAIN STREET, GRAY COURT, SC 29645
(864) 876-3837
(864) 876-1137
Mailing address
PO BOX 96, GRAY COURT, SC 29645-0096
(864) 876-3837
(864) 876-1137
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
17663
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177354
PK
—
05
—
711725
—
SC
Enumeration date
02/01/2018
Last updated
05/17/2018
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