Organization
GOOD VITAL CARE, LLC
Active
Parent organization
GOOD PHARMACY OF ROCK HILL, INC
Other names
Good Vital Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOOD PHARMACY OF ROCK HILL, INC
Authorized official
LAURA J. HYATT-SWEAT (PHARMACISTS)
(803) 327-2092
Entity
Organization
Contact information
Practice address
1243-B EBENEZER ROAD, ROCK HILL, SC 29732-4715
(803) 327-2092
(803) 327-2093
Mailing address
1243-B EBENEZER ROAD, ROCK HILL, SC 29732-4715
(803) 327-2092
(803) 327-2093
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
11331
SC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
11331
SC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
11331
SC
333600000X
Pharmacy
11331
SC
3336H0001X
Home Infusion Therapy Pharmacy
11331
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
711331
MEDICAID HIT
SC
01
—
DE3361
MEDICAID DME
SC
Enumeration date
01/20/2011
Last updated
07/28/2011
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