Organization
HEDGEMARK BRENTWOOD PHARMACY, INC.
Active
Other names
Pharmaceutical Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN S. DURRENCE R.PH. (V-PRESIDENT)
(843) 762-1177
Entity
Organization
Contact information
Practice address
1548 ASHLEY RIVER ROAD, CHARLESTON, SC 29407
(843) 762-1177
(843) 762-4506
Mailing address
1548 ASHLEY RIVER ROAD, CHARLESTON, SC 29407
(843) 762-1177
(843) 762-4506
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
333600000X
Pharmacy
50-002227
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
561663
—
SC
Enumeration date
01/19/2006
Last updated
01/13/2022
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