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Organization

PINE RIDGE INVESTORS

Active
Other names
Pine Ridge Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE MCHUGH (PRESIDENT)
(803) 939-8489
Entity
Organization

Contact information

Practice address
634 A PINE RIDGE DR, WEST COLUMBIA, SC 29172
(803) 955-3404
(803) 955-3406
Mailing address
PO BOX 310, GASTON, SC 29053-0310

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
50010273
SC
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1750527834
SC
01
4228385
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
12/19/2008
Last updated
01/22/2024
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