Organization
VINCENTS DRUG STORE AND SODA FOUNTAIN
Active
Other names
VINCENTS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CAIN BS (PRESIDENT)
(888) 479-2000
Entity
Organization
Contact information
Practice address
110 PLANTED ROW LANE, JOHNS ISLAND, SC 29455
(843) 243-0007
(843) 243-0039
Mailing address
130 GARDNERS CIR # 122, JOHNS ISLAND, SC 29455-5467
(843) 243-0007
(843) 243-0039
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9712
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2092739
PK
—
05
—
782460
—
SC
Enumeration date
10/20/2006
Last updated
02/21/2017
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