Organization
PIGGLY WIGGLY SOUTH INC
Active
Other names
SUP RX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MCLEOD JR. (OWNER)
(803) 773-6378
Entity
Organization
Contact information
Practice address
1455 S GUIGNARD DR, SUMTER, SC 29150-7479
(803) 778-5758
(803) 778-5763
Mailing address
1455 S GUIGNARD DR, SUMTER, SC 29150-7479
(803) 778-5758
(803) 778-5763
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5038
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2091737
PK
—
05
—
729866
—
SC
05
—
750384
—
SC
Enumeration date
10/10/2006
Last updated
07/16/2021
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