Organization
TRACYS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH TRACY (OWNER)
(843) 549-7716
Entity
Organization
Contact information
Practice address
637 PADGETT LOOP, WALTERBORO, SC 29488-4149
(843) 549-7716
(843) 549-6063
Mailing address
637 PADGETT LOOP, WALTERBORO, SC 29488-4149
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2571
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4206997
OTHER ID NUMBER
—
05
—
700915
—
SC
Enumeration date
02/19/2007
Last updated
09/13/2007
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