Organization
MCLEOD PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ROBERSON RPH (RPH)
(803) 484-6115
Entity
Organization
Contact information
Practice address
127 N MAIN ST, BISHOPVILLE, SC 29010-1413
(803) 484-6115
(803) 484-4128
Mailing address
127 N MAIN ST, BISHOPVILLE, SC 29010-1413
(803) 484-6115
(803) 484-4128
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
20160142
SC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
8364
SC
3336C0003X
Community/Retail Pharmacy
8364
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
783646
—
SC
05
—
DM0757
—
SC
05
—
EN2113
—
SC
Enumeration date
10/04/2005
Last updated
12/28/2016
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