Organization
FAIRFAX PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL B. DAVIS (PRESIDENT)
(803) 632-2055
Entity
Organization
Contact information
Practice address
1275 ALLENDALE FAIRFAX HWY, FAIRFAX, SC 29827-9124
(803) 632-2055
(803) 632-1708
Mailing address
PO BOX 366, FAIRFAX, SC 29827-0366
(803) 632-2055
(803) 632-1708
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
50005433
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE1145
—
SC
Enumeration date
12/18/2006
Last updated
08/22/2020
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