Organization
MCLEOD HEALTH CLARENDON LTC PHARMACY
Active
Parent organization
MCLEOD HEALTH
Other names
Cypress Center LTC Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCLEOD HEALTH
Authorized official
SAMUEL FULTON ERVIN III (SR VP AND CFO)
(843) 777-2910
Entity
Organization
Contact information
Practice address
50 E HOSPITAL ST, STE 1B, MANNING, SC 29102-3149
(803) 435-5272
(803) 435-5271
Mailing address
50 E HOSPITAL ST, STE 1B, MANNING, SC 29102-3149
(803) 435-5272
(803) 435-5271
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
16726
SC
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163851
PK
—
05
—
722205
—
SC
Enumeration date
10/20/2005
Last updated
02/25/2019
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