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Organization
PINE RIDGE INVESTORS
Active
Organization
PINE RIDGE INVESTORS
Active
Other names
Pine Ridge Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE MCHUGH (PRESIDENT)
(803) 939-8489
Entity
Organization
Contact information
Practice address
634 A PINE RIDGE DR, WEST COLUMBIA, SC 29172
(803) 955-3404
(803) 955-3406
Mailing address
PO BOX 310, GASTON, SC 29053-0310
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
50010273
SC
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750527834
—
SC
01
—
4228385
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/19/2008
Last updated
01/22/2024
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