Organization
PROFESSIONAL PHARMACY AT MT VIEW IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAULA JAGINA KING JR. RPH (PHARMACIST IN CHARGE)
(864) 877-4281
Entity
Organization
Contact information
Practice address
428 MEMORIAL DRIVE EXTENSION, GREER, SC 29651-1818
(864) 877-4281
(864) 877-4077
Mailing address
428 MEMORIAL DRIVE EXT, GREER, SC 29651-1818
(864) 877-4281
(864) 877-4077
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
50001504
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4210592
NABP NUMBER
—
05
—
715040
—
SC
Enumeration date
11/21/2005
Last updated
05/25/2016
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