Organization
MEDI-FARE DRUG & HOME HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT BALOGA-STEPHENS PHARM D (OWNER/PRESIDENT)
(864) 839-6384
Entity
Organization
Contact information
Practice address
300 W PINE ST, BLACKSBURG, SC 29702-1548
(864) 839-6500
(864) 839-3513
Mailing address
300 W PINE ST, BLACKSBURG, SC 29702-1548
(864) 839-6500
(864) 839-3513
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE2372
—
SC
Enumeration date
10/11/2005
Last updated
05/29/2012
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