Organization
PAWLEYS ISLAND PHARM AT LITCHFIELD
Active
Other names
pawleys island pharmacy of litchfield
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN A COX RPH (OWNER)
(843) 314-0498
Entity
Organization
Contact information
Practice address
115 WILLBROOK BLVD UNIT A, PAWLEYS ISLAND, SC 29585-6542
(843) 314-0498
(843) 314-0580
Mailing address
115 WILLBROOK BLVD UNIT A, PAWLEYS ISLAND, SC 29585-6542
(843) 314-0498
(843) 314-0580
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
7379930001
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
715334
—
SC
01
—
7379930001
MEDICARE PART B PROVIDER
SC
Enumeration date
04/05/2016
Last updated
04/05/2016
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