Organization
KJ 'S PHARMACY,INC
Active
Other names
KJ Pharmacy #129
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER PLAYER RPH (PHARMACIST IN CHARGE)
(843) 374-1110
Entity
Organization
Contact information
Practice address
240 KELLEY ST, LAKE CITY, SC 29560-2416
(843) 374-1110
(843) 374-1117
Mailing address
240 KELLEY ST, LAKE CITY, SC 29560-2416
(843) 374-1110
(843) 374-1117
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15075
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144526
PK
—
05
—
715075
—
SC
Enumeration date
03/10/2014
Last updated
04/19/2018
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