Organization
INGATE PROFESSIONAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRECK KLEIN RPH CGP (PRESIDENT AND OWNER)
(803) 648-8330
Entity
Organization
Contact information
Practice address
400 LAURENS ST NW, AIKEN, SC 29801-3916
(803) 648-8330
(803) 648-8743
Mailing address
400 LAURENS ST NW, AIKEN, SC 29801-3916
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
50004482
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4222080
OTHER ID NUMBER
—
05
—
744827
—
SC
Enumeration date
05/12/2006
Last updated
09/13/2007
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