Organization
PIGGLY WIGGLY OF WESTMART INC
Active
Other names
SUP RX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVE DUBOSE PHARMD (PHARMACY MANAGER)
(803) 773-6378
Entity
Organization
Contact information
Practice address
1011 BROAD ST, SUMTER, SC 29150-2504
(803) 773-6378
(803) 775-6771
Mailing address
1011 BROAD ST, SUMTER, SC 29150-2504
(803) 773-6378
(803) 775-6771
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
50002786
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2090384
PK
—
05
—
727867
—
SC
05
—
DE2042
—
SC
Enumeration date
09/21/2006
Last updated
08/01/2025
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