Organization
LONGS DRUGSTORES OF SC INC
Active
Other names
LONGS KILBOURNE RD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL FROST BS (DIRECTOR OF BUSINESS DEV)
(404) 583-6945
Entity
Organization
Contact information
Practice address
630 KILBOURNE RD, COLUMBIA, SC 29205-2827
(803) 254-4619
(803) 765-0466
Mailing address
PO BOX 602682, CHARLOTTE, NC 28260-2682
(803) 254-4619
(803) 765-0466
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15057
SC
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538252671
—
SC
01
—
2090209
PK
—
Enumeration date
10/02/2006
Last updated
05/15/2014
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