Organization
MAULDIN FAMILY PHARMACY INC
Active
Other names
MAULDIN FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES TIDMARSH RPH (PRESIDENT)
(864) 288-2600
Entity
Organization
Contact information
Practice address
505 N MAIN ST, STE A, MAULDIN, SC 29662-2345
(864) 288-2600
(864) 288-5608
Mailing address
505 N MAIN ST, STE A, MAULDIN, SC 29662-2345
(864) 288-2600
(864) 288-5608
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1874
SC
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2089291
PK
—
05
—
718748
—
SC
Enumeration date
09/21/2006
Last updated
07/19/2018
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