Organization
SUP-RX PHARMACY #53
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY MCLEOD (OWNER)
(803) 775-1334
Entity
Organization
Contact information
Practice address
401 PEARL ST, DARLINGTON, SC 29532-3814
(843) 393-2552
(843) 393-9811
Mailing address
401 PEARL ST, DARLINGTON, SC 29532-3814
(843) 393-2552
(843) 393-9811
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
50-000803
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4203751
NCDP NUMBER
—
05
—
708033
—
SC
Enumeration date
06/09/2005
Last updated
03/07/2023
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