Organization
PICKWICK PHARMACY INC
Active
Other names
PICKWICK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL RAY PHARM D (PHARMACIST)
(864) 277-4180
Entity
Organization
Contact information
Practice address
3219 AUGUSTA ST, GREENVILLE, SC 29605-2145
(864) 277-4180
(864) 277-4181
Mailing address
3219 AUGUSTA ST, GREENVILLE, SC 29605-2145
(864) 277-4180
(864) 277-4181
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
16613
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2087915
PK
—
05
—
793691
—
SC
Enumeration date
10/26/2006
Last updated
09/22/2016
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