# PIGGLY WIGGLY SOUTH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUP RX PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972690857
- **Authorized official:** WILLIAM MCLEOD JR. (OWNER)
- **Authorized official phone:** (803) 773-6378

## Contact information

- **Practice address:** 1455 S GUIGNARD DR, SUMTER, SC 29150-7479
- **Practice address phone:** (803) 778-5758
- **Practice address fax:** (803) 778-5763
- **Mailing address:** 1455 S GUIGNARD DR, SUMTER, SC 29150-7479
- **Mailing address phone:** (803) 778-5758
- **Mailing address fax:** (803) 778-5763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 5038 | SC | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 07/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2091737 | PK | — |
| 05 | — | 729866 | — | SC |
| 05 | — | 750384 | — | SC |