Provider Demographics
NPI:1265045322
Name:PTVP
Entity Type:Organization
Organization Name:PTVP
Other - Org Name:BUY LOW PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:THADANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-572-5727
Mailing Address - Street 1:705 MOSSWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-5366
Mailing Address - Country:US
Mailing Address - Phone:864-572-5727
Mailing Address - Fax:864-572-5728
Practice Address - Street 1:8007 WARREN H ABERNATHY HWY
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-2449
Practice Address - Country:US
Practice Address - Phone:864-572-5727
Practice Address - Fax:864-572-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7Z1111Medicaid