Organization
PLTCP LLC
Active
Other names
Palmetto Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DUANE EVERETT (CHIEF OPERATING OFFICER)
(803) 397-8904
Entity
Organization
Contact information
Practice address
317 ZIMALCREST DR, COLUMBIA, SC 29210-6833
(803) 731-0203
(866) 935-3629
Mailing address
4900 PERRY HWY, BUILDING 2, 3RD FL, PITTSBURGH, PA 15229-2220
(412) 931-3131
(412) 931-2361
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
14061
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4225454
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/22/2006
Last updated
10/08/2012
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