Organization
LONGS DRUGSTORES OF SC INC
Active
Other names
LONGS MEDICAL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL FROST (DIRECTOR OF BUSINESS DEV)
(404) 583-6945
Entity
Organization
Contact information
Practice address
115 BLARNEY DR STE 105, SUITE 105, COLUMBIA, SC 29223-6291
(803) 788-9608
(803) 788-7170
Mailing address
PO BOX 602688, CHARLOTTE, NC 28260-2688
(803) 788-9608
(803) 788-7170
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15059
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053403964
—
SC
01
—
2089902
PK
—
Enumeration date
09/28/2006
Last updated
03/19/2014
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