Organization
WATEREE PLAZA DRUG CORP
Active
Other names
LIGGETT COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES F SMITH RPH (PHARMACIST)
(803) 438-8234
Entity
Organization
Contact information
Practice address
1053 HWY 1, PATTERSON PLAZA, LUGOFF, SC 29078
(803) 438-8234
(803) 438-8234
Mailing address
PO BOX 236, LUGOFF, SC 29078
(803) 438-8234
(803) 438-8234
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE2385
—
SC
Enumeration date
11/02/2006
Last updated
07/07/2008
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