Organization
H AND M HEALTHCARE
Active
Other names
Tyler Brothers Prescription Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
TAVIA FOGLE (OWNER)
(803) 247-2133
Entity
Organization
Contact information
Practice address
123 A EARL STREET, WAGENER, SC 29164
(803) 564-7034
Mailing address
PO BOX 278, NORTH, SC 29112-0278
(803) 247-2133
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15838
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149745
PK
—
Enumeration date
03/30/2015
Last updated
03/30/2015
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