Individual
CHARLES RAY SANDERS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
701 GROVE RD, EMPLOYEE PAVILION, GREENVILLE, SC 29605-5611
(864) 455-1325
Mailing address
255 ENTERPRISE BLVD, SUITE 250, GREENVILLE, SC 29615-6300
(864) 454-0810
(864) 454-1130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10855
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10855
SC LICENSE
SC
Enumeration date
11/13/2007
Last updated
11/13/2007
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