# JACK P. PADGETT JR.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PADGETT'S DRIVE IN PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851474100
- **Authorized official:** JACK PERSHING PADGETT JR. RPH (PHARMACIST)
- **Authorized official phone:** (803) 245-4298

## Contact information

- **Practice address:** 540 NORTH ST, BAMBERG, SC 29003-1319
- **Practice address phone:** (803) 245-4298
- **Practice address fax:** (803) 245-1232
- **Mailing address:** 540 NORTH ST, BAMBERG, SC 29003-1319
- **Mailing address phone:** (803) 245-4298
- **Mailing address fax:** (803) 245-1232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 5001664 | SC | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 12/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4202329 | OTHER ID NUMBER | — |
| 05 | — | 716647 | — | SC |