Organization
ORANGE CUT RATE DRUG STORE, INC.
Active
Other names
Grove Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES PAIGE THOMPSON JR. RPH (OWNER)
(803) 534-1164
Entity
Organization
Contact information
Practice address
1324 GROVE PARK NE, ORANGEBURG, SC 29115-2455
(803) 534-1164
(803) 536-2962
Mailing address
PO BOX 701, ORANGEBURG, SC 29116-0701
(803) 534-1164
(803) 536-2962
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
50-001928
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
619281
—
SC
05
—
DPE090
—
SC
05
—
EN2072
—
SC
Enumeration date
12/24/2007
Last updated
08/30/2016
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