Organization
MODIFICARE LLC
Active
Other names
MEDI-SAVE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DENO SEBASTIAN (OWNER)
(757) 763-8588
Entity
Organization
Contact information
Practice address
1023A W DEKALB ST, CAMDEN, SC 29020-4162
(803) 424-0064
(803) 425-8173
Mailing address
1023A W DEKALB ST, CAMDEN, SC 29020-4162
(803) 424-0064
(803) 425-8173
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6496
SC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2092185
PK
—
05
—
764962
—
SC
05
—
7Z1235
—
SC
05
—
DE2114
—
SC
Enumeration date
06/16/2006
Last updated
06/09/2023
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