Organization
BI-LO PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY LIFSEY (PHARMACY MANAGER)
(843) 761-5506
Entity
Organization
Contact information
Practice address
110 S HIGHWAY 52, MONCKS CORNER, SC 29461-3954
(843) 761-5506
(843) 761-0965
Mailing address
110 S HIGHWAY 52, MONCKS CORNER, SC 29461-3954
(843) 761-5506
(843) 761-0965
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
9437
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9437
LLR
SC
Enumeration date
11/22/2011
Last updated
11/22/2011
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