Organization
GATEWAY DRUG STORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS FREDDIE MOORE RPH. (PRESIDENT)
(843) 756-5134
Entity
Organization
Contact information
Practice address
3997 MEETING ST, LORIS, SC 29569-3053
(843) 756-5134
(843) 756-0689
Mailing address
3997 MEETING ST, LORIS, SC 29569-3053
(843) 756-5134
(843) 756-0689
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
50-000971
SC
Other
Enumeration date
10/24/2005
Last updated
08/22/2020
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