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Individual

MR. AVERITTE BURNEY PACE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMACY BS

Contact information

Practice address
116 S MAIN ST, NICHOLS, SC 29581-0207
(843) 526-2171
(843) 526-1705
Mailing address
PO BOX 207, 401 SOUTH NICHOLS STREET, NICHOLS, SC 29581-0207
(843) 526-2257
(843) 526-1705

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3526
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3526
PHARMACIST
SC
Enumeration date
03/15/2012
Last updated
03/15/2012
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