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Organization

MOON'S DRUG STORE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY LEE SMITH RPH (PRES./OWNER)
(864) 647-8770
Entity
Organization

Contact information

Practice address
132 E MAIN ST, WESTMINSTER, SC 29693-1753
(864) 647-8770
(864) 647-2906
Mailing address
132 E MAIN ST, WESTMINSTER, SC 29693-1753
(864) 647-8770
(864) 647-2906

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
037117538
SC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DME236
SC
Enumeration date
07/15/2006
Last updated
05/06/2026
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