# FAIRFAX PHARMACY INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942250816
- **Authorized official:** CAROL BETH DAVIS (PRESIDENT)
- **Authorized official phone:** (803) 632-2055

## Contact information

- **Practice address:** 1275 ALLENDALE FAIRFAX HWY, FAIRFAX, SC 29827-9124
- **Practice address phone:** (803) 632-2055
- **Practice address fax:** (803) 632-1708
- **Mailing address:** PO BOX 366, 1275 ALLENDALE-FAIRFAX HWY, FAIRFAX, SC 29827-0366
- **Mailing address phone:** (803) 632-2055
- **Mailing address fax:** (803) 632-1708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | SC | Yes |

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4215388 | NABP OR NCPDP | SC |
| 05 | — | 754336 | — | SC |